Waaler G, Ludvigsen T C, Stenwig A E
Department of Surgery, Aust-Agder Central Hospital, Arendal, Norway.
Eur Urol. 1990;18(3):179-83. doi: 10.1159/000463904.
The clinical significance of dividing incidental prostatic cancer into T0 focal (A1) and T0 diffuse (A2) is well documented, but criteria for the distinction vary considerably. Eighty-four patients with incidental prostatic cancer over a 5-year period comprise all newly diagnosed cases from an area of 94,000 inhabitants in the Aust-Agder County in Norway. This represents 13% of the patients operated upon for apparently benign prostatic hyperplasia. Of these patients, 80 with a mean age of 73.9 years did not receive any additional treatment after prostatectomy until progression (deferred treatment) and were followed up for 2-7 years. Three chips or less of well-differentiated cancer were defined as T0 focal (n = 18), all other cases were T0 diffuse (n = 62). Sixty-nine patients (86%) were free of progression. Eighteen patients died of causes unrelated to prostatic cancer. Progression occurred in 11 patients (14%) at a mean time interval of 39 months after diagnosis, and 3 patients died of prostatic cancer. Related to grade, progression occurred in 2% of the G1 tumors, in 25% of G2, and in 40% of the G3 tumors. When a tumor volume of 25% was chosen as level of distinction between T0 focal and T0 diffuse, 25 patients (31%) changed the stage to T0 focal without any impact on prognosis.
将偶发前列腺癌分为T0局灶性（A1）和T0弥漫性（A2）的临床意义已有充分记录，但区分标准差异很大。在5年期间，84例偶发前列腺癌患者涵盖了挪威奥斯特-阿格德尔郡94000名居民区域内所有新诊断的病例。这占因明显良性前列腺增生而接受手术患者的13%。在这些患者中，80例平均年龄为73.9岁，前列腺切除术后直至病情进展均未接受任何额外治疗（延迟治疗），并随访了2至7年。分化良好的癌灶为3个或更少切片被定义为T0局灶性（n = 18），所有其他病例为T0弥漫性（n = 62）。69例患者（86%）无病情进展。18例患者死于与前列腺癌无关的原因。11例患者（14%）在诊断后平均39个月出现病情进展，3例患者死于前列腺癌。与分级相关，G1肿瘤中2%出现病情进展，G2肿瘤中25%出现病情进展，G3肿瘤中40%出现病情进展。当选择肿瘤体积25%作为T0局灶性和T0弥漫性的区分标准时，25例患者（31%）分期变为T0局灶性，但对预后无任何影响。
