Saito K, Takahashi T, Nomura S
Department of Urology, Hatano Red Cross Hospital.
Hinyokika Kiyo. 1989 Aug;35(8):1347-53.
Fourteen patients with incidentally diagnosed carcinoma of the prostate were reviewed. The frequency of the incidental prostatic carcinoma in our clinic was approximately 7.3% of 191 patients operated for benign prostatic hypertrophy. Five patients with focal and well differentiated carcinoma (stage A1) were managed expectantly with no treatment. Two patients with focal and moderately differentiated carcinoma (stage A2) and three patients with stage A1 cancer were treated by means of chlormadinone acetate. Total retropubic prostatectomy and pelvic lymph-node dissection was performed in four patients with diffuse prostatic carcinoma (stage A2). No serious complication occurred without minimal stress incontinence in one patient. Three patients had diffuse residual carcinoma in the total prostatectomy specimens. In one of them capsular penetration of carcinoma cells was discovered. Follow up was performed for 1.5-7 years (mean 43 months) by repeated transrectal needle biopsy, bone scan and serum phosphatase. Metastasis and recurrence have not developed in any patient. Two patients died without evidence of cancer. The remaining patients are alive without evidence of disease. Radical operation is recommended for patients with stage A2 prostatic carcinoma after transurethral resection of prostate.
对14例偶然诊断为前列腺癌的患者进行了回顾性研究。在我们诊所，偶然发现的前列腺癌在191例因良性前列腺增生而接受手术的患者中发生率约为7.3%。5例局限性高分化癌（A1期）患者采取观察等待，未进行治疗。2例局限性中分化癌（A2期）患者和3例A1期癌症患者接受了醋酸氯地孕酮治疗。4例弥漫性前列腺癌（A2期）患者接受了耻骨后前列腺全切除术及盆腔淋巴结清扫术。无一例出现严重并发症，仅1例患者有轻微压力性尿失禁。在前列腺全切除标本中，3例患者有弥漫性残留癌。其中1例发现癌细胞侵犯包膜。通过重复经直肠穿刺活检、骨扫描和血清磷酸酶检查进行了1.5至7年（平均43个月）的随访。所有患者均未发生转移和复发。2例患者死亡，未发现癌症迹象。其余患者存活，无疾病迹象。对于经尿道前列腺切除术后的A2期前列腺癌患者，建议行根治性手术。
