deKernion J B, Neuwirth H, Stein A, Dorey F, Stenzl A, Hannah J, Blyth B
Department of Surgery, UCLA School of Medicine.
J Urol. 1990 Sep;144(3):700-3. doi: 10.1016/s0022-5347(17)39559-9.
Early endocrine therapy after radical retropubic prostatectomy was compared to radical prostatectomy alone (nonearly endocrine therapy) for the treatment of carcinoma of the prostate with lymph node metastases. Our retrospective analysis demonstrated that the 2 cohorts were similar with respect to patient age, Gleason sum score, seminal vesicle invasion, lymph node involvement, tumor volume and pathological stage of the primary tumor. The cause-specific survival of the entire group was 84% at 60 months and 78% at 98 months. The cause-specific curves for the early and nonearly endocrine therapy group were not significantly different (p less than 0.194), although the estimated 9-year survival rates were 91 and 71%, respectively. Survival free of disease was significantly prolonged in the early endocrine therapy group (p less than 0.030), with a 9-year estimated rate free of disease of 67% versus 32% in the nonearly endocrine therapy group. Followup prostate specific antigen serum levels were analyzed and the value as a progression marker is discussed. These data suggest that a radical operation plus early endocrine therapy is effective palliation in selected patients with low volume lymph node metastases, producing clinical survival free of disease in most patients.
对于伴有淋巴结转移的前列腺癌患者，将耻骨后前列腺癌根治术后早期内分泌治疗与单纯前列腺癌根治术（非早期内分泌治疗）进行了比较。我们的回顾性分析表明，两组在患者年龄、 Gleason总分、精囊侵犯、淋巴结受累、肿瘤体积和原发肿瘤病理分期方面相似。整个组的病因特异性生存率在60个月时为84%，在98个月时为78%。早期和非早期内分泌治疗组的病因特异性曲线无显著差异（p小于0.194），尽管估计的9年生存率分别为91%和71%。早期内分泌治疗组无病生存期显著延长（p小于0.030），9年无病估计率为67%，而非早期内分泌治疗组为32%。分析了随访前列腺特异性抗原血清水平，并讨论了其作为进展标志物的价值。这些数据表明，根治性手术加早期内分泌治疗对选定的低体积淋巴结转移患者是有效的姑息治疗方法，可使大多数患者实现无病临床生存。
