Schmeller N T
Urologische Klinik und Poliklinik, Universität München.
Fortschr Med. 1991 Sep 30;109(28):559-62.
Diagnostic, therapeutic and palliative procedures in carcinoma of the prostate are discussed. Staging lymphadenectomy of pelvic lymph nodes has recently been performed via the laparoscope. Our results achieved with this procedure in, to date, 25 patients revealed lymph nodes metastasis in 50% of the cases, although the CT scan was unremarkable. Radical prostatovesiculectomy is accepted as the method of choice for the curative treatment of non-metastatic carcinoma of the prostate. Life expectancy following radical prostatectomy in tumor stage 2 or below, is similar to the general population of the same age. The palliative procedure of choice in prostatic carcinoma is plastic orchiectomy, in which the androgen-producing gonadal tissue is removed and testicular coat, together with the epididymi left in situ. With this approach, partial remission, rarely even complete remission, can be achieved in 80% of the patients. Information in the literature on prolongation of survival as a result of androgen deprivation is, however, contradictory.
本文讨论了前列腺癌的诊断、治疗及姑息治疗方法。近期已通过腹腔镜进行盆腔淋巴结分期清扫术。我们采用该方法对25例患者进行治疗的结果显示，尽管CT扫描无明显异常，但50%的病例存在淋巴结转移。根治性前列腺精囊切除术被公认为非转移性前列腺癌的首选治疗方法。肿瘤分期为2期及以下的患者，根治性前列腺切除术后的预期寿命与同年龄的普通人群相似。前列腺癌的首选姑息治疗方法是整形睾丸切除术，即切除产生雄激素的性腺组织，保留睾丸包膜及附睾。采用这种方法，80%的患者可实现部分缓解，极少数情况下甚至可实现完全缓解。然而，文献中关于雄激素剥夺延长生存期的信息相互矛盾。
