Bott Simon R J, Freeman A Alex, Stenning Sally, Cohen Jonathan, Parkinson M Constance
Institute of Urology, University College London, London, UK.
BJU Int. 2005 Jan;95(1):34-9. doi: 10.1111/j.1464-410X.2005.05245.x.
To examine the preoperative features and pathological outcomes of clinical significance of 1001 consecutive essentially unscreened men who had a radical prostatectomy (RP) in the UK between 1988 and 2002, and their changes over time.
The details of men whose RP specimen was submitted for analysis were entered into the RP database held at the University College Hospital, London; the National Health Service and private patients of 17 surgeons were included. The age, mode of diagnosis, preoperative prostate specific antigen (PSA) level, biopsy and RP findings were compared over time.
The mean (range) age of the men was 62 (40-76) years, the median PSA 8 (0.1-146) ng/mL and the median biopsy Gleason sum score 6; these preoperative features did not change over the study period. The diagnosis of prostate cancer was made by transurethral resection of the prostate alone in 48 men (5%). The maximum number of patients receiving neoadjuvant androgen ablation was 21 (33%) in 1996, and subsequently declined. The median (range) RP Gleason sum score was 7 (4-9). The biopsy Gleason score correlated with the prostatectomy Gleason score in 252 (47%) of 536 men, being lower in 170 (32%) and higher in 113 (21%). The median tumour volume was 2 mL (focus of invasive acini - 31 mL) and the incidence of positive intra- and extraprostatic margins was 52%. Both tumour volume and extraprostatic margin positivity declined with time.
The preoperative features and pathological findings from this UK series are similar to those of other reported cohorts from unscreened populations. The incidence of positive extraprostatic surgical margins, tumour volume and stage decreased with time.
研究1988年至2002年间在英国连续接受根治性前列腺切除术（RP）的1001例基本未经筛查的男性患者的术前特征及具有临床意义的病理结果，以及这些特征随时间的变化情况。
将提交RP标本进行分析的男性患者详细信息录入伦敦大学学院医院保存的RP数据库；纳入了17位外科医生的国民医疗服务体系（NHS）患者和私人患者。对不同时间段患者的年龄、诊断方式、术前前列腺特异性抗原（PSA）水平、活检及RP结果进行比较。
这些男性患者的平均（范围）年龄为62（40 - 76）岁，PSA中位数为8（0.1 - 146）ng/mL，活检Gleason总分中位数为6分；这些术前特征在研究期间未发生变化。仅通过经尿道前列腺切除术诊断出前列腺癌的患者有48例（5%）。1996年接受新辅助雄激素剥夺治疗的患者最多，为21例（33%），随后有所下降。RP Gleason总分中位数（范围）为7（4 - 9）。536例男性患者中，252例（47%）活检Gleason评分与前列腺切除术后Gleason评分相关，其中170例（32%）较低，113例（21%）较高。肿瘤体积中位数为2 mL（浸润性腺泡灶 - 31 mL），前列腺内外切缘阳性率为52%。肿瘤体积和前列腺外切缘阳性率均随时间下降。
该英国系列研究的术前特征和病理结果与其他未筛查人群的报道队列相似。前列腺外手术切缘阳性、肿瘤体积和分期的发生率随时间下降。
