Peyromaure Michaël, Debré Bernard, Mao Kaili, Zhang Guoqiang, Wang Yiran, Sun Zhongquan, Xu Danfeng, Jiang Jun, Sun Yinghao
Department of Urology, Cochin Hospital, Paris, France.
J Urol. 2005 Nov;174(5):1794-7. doi: 10.1097/01.ju.0000176817.46279.93.
In China the incidence of prostate cancer (PCa) is low and sparse data are available regarding its management. We analyzed the management of PCa at 6 Chinese urological institutions.
A retrospective analysis was performed of 431 consecutive patients treated for PCa at 6 Chinese institutions, including 5 in the divisions of Shanghai and 1 in the province of Chongqing, between January 2000 and December 2004. Tumor characteristics, therapeutic options and patient outcomes were recorded.
At diagnosis median patient age was 72 years and median prostate specific antigen was 46.1 ng/ml. Most PCa cases were revealed by urinary symptoms (75.9%) or bone pain (12.8%). PCa was palpable on digital rectal examination in 74% of cases. At least 44 patients (10.2%) had metastases to lymph nodes at diagnosis and 112 (26%) had bone metastases. A total of 236 patients underwent bilateral orchiectomy and 100 received medical hormone therapy, which in 75% consisted of antiandrogen alone. At a median followup of 16.8 months 60% of these patients experienced biological recurrence. Radical prostatectomy was performed in 24 patients as monotherapy or in combination with bilateral orchiectomy. No patient with clinically localized PCa experienced biological recurrence after radical prostatectomy.
The management of PCa in China differs from that in Western countries. To date surgical castration represents standard treatment. Screening detection of PCa could help detect earlier stage tumors and improve the outcome in patients.
在中国，前列腺癌（PCa）的发病率较低，且关于其治疗的可用数据较少。我们分析了6家中国泌尿外科机构对PCa的治疗情况。
对2000年1月至2004年12月期间在6家中国机构连续治疗的431例PCa患者进行回顾性分析，其中5家在上海，1家在重庆。记录肿瘤特征、治疗选择和患者预后。
诊断时患者中位年龄为72岁，中位前列腺特异性抗原为46.1 ng/ml。大多数PCa病例由泌尿系统症状（75.9%）或骨痛（12.8%）发现。74%的病例直肠指检可触及PCa。诊断时至少44例患者（10.2%）有淋巴结转移，112例（26%）有骨转移。共有236例患者接受双侧睾丸切除术，100例接受药物激素治疗，其中75%仅使用抗雄激素药物。中位随访16.8个月时，这些患者中有60%出现生物学复发。24例患者接受了根治性前列腺切除术，作为单一疗法或与双侧睾丸切除术联合使用。临床局限性PCa患者在根治性前列腺切除术后均未出现生物学复发。
中国PCa的治疗与西方国家不同。迄今为止，手术去势是标准治疗方法。PCa的筛查检测有助于发现早期肿瘤并改善患者预后。
