Gottesman J E, Tesh D G, Weissman W D
Department of Urology, Swedish Hospital Medical Center, Seattle, Washington.
J Urol. 1991 Nov;146(5):1317-9; discussion 1319-20. doi: 10.1016/s0022-5347(17)38078-3.
We studied 41 patients with localized prostate cancer who underwent bilateral pelvic lymphadenectomy with open insertion of radioactive 125iodine. Followup was a minimum of 5 years. Of the patients 13 died: 10 of recurrent prostatic adenocarcinoma (including 4 of 5 with pathological stage D1 cancer) and 3 of unrelated causes within 2 years of implantation without clinical evidence of prostate cancer. Of the 28 remaining patients 16 have known recurrence of cancer (positive bone scan and increasing prostate specific antigen (PSA) level or positive tissue biopsy]. Six patients have strong suspicion of local recurrence with elevated PSA levels (greater than 4.0 in 5) and increasing induration on digital rectal examination. Only 6 of the 41 patients (14.6%) are without evidence of disease. Openly implanted radioactive 125iodine does not appear to control effectively adenocarcinoma of the prostate.
我们研究了41例局限性前列腺癌患者，这些患者接受了双侧盆腔淋巴结清扫术并开放植入放射性125碘。随访时间至少为5年。在这些患者中，13例死亡：10例死于复发性前列腺腺癌（包括5例病理分期为D1期癌症中的4例），3例在植入后2年内死于无关原因，且无前列腺癌的临床证据。在其余28例患者中，16例已知癌症复发（骨扫描阳性、前列腺特异性抗原（PSA）水平升高或组织活检阳性）。6例患者因PSA水平升高（5例中大于4.0）且直肠指检硬结增加而高度怀疑局部复发。41例患者中只有6例（14.6%）无疾病证据。开放植入放射性125碘似乎不能有效控制前列腺腺癌。
