Rossignol G, Leandri P, Ramon J, Gautier J R
Department of Urology, Saint-Jean Languedoc-Cerou, Toulouse, France.
Eur Urol. 1992;21(4):269-73. doi: 10.1159/000474855.
A total of 115 patients (29 with stage A1 and 86 with stage A2 prostate cancer) underwent radical retropubic prostatectomy. Residual cancer was found in the radical prostatectomy specimens in 11 of the 29 stage A1 patients (38%) and in 66 of the 86 stage A2 patients (77%). Fourteen percent of the stage A1 patients and 29.5% of the stage A2 patients had pathological evidence of disease extension beyond the confined prostate. No perioperative death occurred and no patient suffered rectal injury or was totally incontinent. Early postoperative complications occurred in 6 patients (5%). There were no late complications. Complete urinary control was achieved in 111 patients (96.5%) and stress urinary incontinence was present in 4 patients (3.5%). Sexual function was preserved in 21 of the 26 patients (81%) who underwent a nerve-sparing radical prostatectomy. Follow-up ranged from 12 to 84 months with a mean of 30 months. All patients were alive at the time of this study and only 3 patients suffered disease progression. These 3 patients were among the stage A2 group and had pathological evidence of tumor extension beyond the prostatic capsule. Twenty-six patients who also had evidence of disease extension were alive without evidence of disease. These data demonstrate that patients with stage A disease are at risk for disease progression if left untreated and with a morbidity as low as that achieved in our series, radical prostatectomy should remain an optimal option for tumor control in these patients.
共有115例患者（29例A1期和86例A2期前列腺癌患者）接受了耻骨后根治性前列腺切除术。在29例A1期患者中的11例（38%）以及86例A2期患者中的66例（77%）的前列腺根治性切除标本中发现了残留癌。14%的A1期患者和29.5%的A2期患者有疾病超出前列腺局限范围的病理证据。未发生围手术期死亡，无患者发生直肠损伤或完全失禁。6例患者（5%）出现早期术后并发症。无晚期并发症。111例患者（96.5%）实现了完全控尿，4例患者（3.5%）存在压力性尿失禁。在接受保留神经的根治性前列腺切除术的26例患者中的21例（81%）保留了性功能。随访时间为12至84个月，平均30个月。在本研究时所有患者均存活，仅有3例患者疾病进展。这3例患者属于A2期组，有肿瘤超出前列腺包膜的病理证据。另外26例有疾病进展证据的患者存活且无疾病证据。这些数据表明，A期疾病患者若不治疗有疾病进展风险，且鉴于我们系列研究中所达到的低发病率，根治性前列腺切除术应仍是这些患者控制肿瘤的最佳选择。
