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复发性前列腺癌的临床研究

[Clinical studies on recurrent prostatic cancer].

作者信息

Suzuki K, Nakamura T, Kato N, Suzuki T, Imai K, Yamanaka H

机构信息

Department of Urology, Tatebayashi Kosei Hospital, Gunma.

出版信息

Hinyokika Kiyo. 1991 Jun;37(6):595-600.

PMID:1892007
Abstract

Between 1977 and 1989, we treated 114 new patients with prostatic cancer, and 99 of them responded to initial hormone-based treatment. Recurrence was seen in 28 of the 99 responders. The age at first admission ranged from 56 to 84 years, with a mean of 72.4 years. The mean interval between the start of follow-up and recurrence was 21.0 +/- 15.4 months (M +/- SE). The interval was 33.3 months for patients in stages B2 and C at initial treatment, 34.3 months for those in stage D1, and 15.6 months for those in stage D2. Stage D2 patients showed significantly earlier recurrence than the other patients (p less than 0.05). Patients with well, moderately, or poorly-differentiated adenocarcinoma at initial treatment developed recurrence after 62.5, 14.8, and 23.0 months, respectively, and there was no significant difference due to histological grade. As the mode of recurrence, the appearance of new lesions and the elevation of tumor marker levels were more frequently seen than local progression in patients with progressive disease at initial treatment. Pathological examination showed the tendency of recurrence for higher grade tumors. In comparison with those without recurrence, patients with recurrence had more advanced disease (p. 0.05). Only 11% of the patients showed partial response (PR) and 14.3% showed no change (NC) with multimodal therapy. The actual survival rates following initial treatment were 51.5% and 31.2% at 3 and 5 years, respectively, while those after recurrence were 49.3% and 12.5% at 1 and 3 years.

摘要

1977年至1989年间,我们治疗了114例前列腺癌新患者,其中99例对初始激素治疗有反应。99例有反应者中有28例出现复发。首次入院年龄在56岁至84岁之间,平均年龄为72.4岁。随访开始至复发的平均间隔时间为21.0±15.4个月(均值±标准误)。初始治疗时处于B2和C期的患者间隔时间为33.3个月,D1期患者为34.3个月,D2期患者为15.6个月。D2期患者的复发明显早于其他患者(p<0.05)。初始治疗时为高分化、中分化或低分化腺癌的患者分别在62.5、14.8和23.0个月后出现复发,组织学分级无显著差异。作为复发模式,初始治疗时有进展性疾病的患者中,新病灶出现和肿瘤标志物水平升高比局部进展更常见。病理检查显示高分级肿瘤有复发倾向。与未复发患者相比,复发患者的疾病进展更严重(p<0.05)。多模式治疗中只有11%的患者显示部分缓解(PR),14.3%的患者显示无变化(NC)。初始治疗后的实际3年和5年生存率分别为51.5%和31.2%,而复发后的1年和3年生存率分别为49.3%和12.5%。

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