Finamanti Marco, Antonelli Alessandro, Contessa Pierangelo, Cosciani Cunico Sergio, Simeone Claudio
Unità operativa di Urologia, Spedali Civili di Brescia, Università degli Studi di Brescia, Brescia - Italy.
Urologia. 2011 Oct-Dec;78(4):283-7. doi: 10.5301/RU.2011.8835.
Prostate cancer is a disease with a variable clinical course. The possible impact on oncological outcome of non-acinar prostate cancer has not been established yet, especially for ductal adenocarcinoma due to its low frequency, so that its clinical management is not well codified. The disease occurs more often already at an advanced stage of diagnosis, with clinically detectable tumors and advanced pathological stage, partly because of the lack of specific tumor markers, given the poor correlation between PDA and PSA values. In the period between 1997 and 2010 56 patients with PDA on a total of 1265 new diagnoses of cancer were identified, for an overall incidence of 4.5%. 41 patients (75%) had a PDA type II histology, while 15 patients (25%) a PDA type I (pure form). Generally, a surgical treatment was carried out in patients with life expectancy greater than 10/15 years/under 70 years of age, non-metastatic tumors and found to be liable to local resection; radiation therapy was given with 70 Gy in cases with a shorter life expectancy and/or an illness judged unresectable for local extension; hormonal therapy was indicated in all other clinical situations. For all patients, the clinical and pathologic data and follow-ups were re-evaluated. The overall survival and disease-free survival were then analyzed. Given the low incidence of this pathology the relevant literature is poor and therefore the therapeutic approach is not univocal. This paper retrospectively reviews our experience with prostatic ductal adenocarcinoma.
前列腺癌是一种临床病程多变的疾病。非腺泡型前列腺癌对肿瘤学结局的可能影响尚未明确，尤其是导管腺癌，因其发病率低，所以其临床管理尚未得到很好的规范。该疾病在诊断时往往已处于晚期，临床可检测到肿瘤且病理分期较晚，部分原因是缺乏特异性肿瘤标志物，鉴于导管腺癌（PDA）与前列腺特异性抗原（PSA）值之间相关性较差。在1997年至2010年期间，在总共1265例新诊断的癌症患者中，有56例患有PDA，总体发病率为4.5%。41例患者（75%）为II型PDA组织学，而15例患者（25%）为I型PDA（纯形式）。一般来说，对于预期寿命大于10/15年/年龄小于70岁、无转移肿瘤且适合局部切除的患者进行手术治疗；对于预期寿命较短和/或因局部扩展被判定无法切除的疾病，给予70 Gy的放射治疗；在所有其他临床情况下采用激素治疗。对所有患者的临床和病理数据以及随访情况进行了重新评估。然后分析了总生存期和无病生存期。鉴于这种病理类型的发病率较低，相关文献较少，因此治疗方法并不统一。本文回顾性地总结了我们在前列腺导管腺癌方面的经验。
