Blute M L, Nativ O, Zincke H, Farrow G M, Therneau T, Lieber M M
Department of Urology, Mayo Clinic, Rochester, Minnesota.
J Urol. 1989 Nov;142(5):1262-5. doi: 10.1016/s0022-5347(17)39051-1.
From 1966 to 1980, 315 patients underwent bilateral pelvic lymphadenectomy and radical retropubic prostatectomy without adjuvant treatment for clinically and pathologically localized adenocarcinoma of the prostate. Followup was 5 to 21 years, with a median of 8 years. The disease was pathological stage A in 24 patients (8%) and pathological stage B in 291 (92%). A total of 45 patients (14.2%) experienced progression. Over-all, 28 patients (8.9%) suffered local recurrence at a mean of 6.6 years postoperatively (median 5.5 years). Local recurrence was noted as late as 15 years postoperatively. Over-all, systemic progression was observed in 25 patients (8%) after a mean of 4.7 years (median 6 years). Eight patients (2.5%) experienced local and systemic failure. The projected local and systemic failure rates at 15 years were 22% and 15%, respectively. Disease-specific survival at 15 years was 93%, since only 11 patients (3.4%) died of prostate cancer. In an age-matched case control analysis, after all prognostic variables were analyzed (Mayo grade, Gleason score, capsule involvement, number of foci, volume of tumor and deoxyribonucleic acid tumor ploidy), progression was related to nondiploid deoxyribonucleic acid tumor ploidy (p less than 0.0004) as determined by flow cytometry in 63% of the patients who evidenced progression versus 8% of the nonrecurrent group.
1966年至1980年期间，315例患者接受了双侧盆腔淋巴结清扫术和耻骨后根治性前列腺切除术，未接受针对临床和病理分期为局限性前列腺腺癌的辅助治疗。随访时间为5至21年，中位时间为8年。24例患者（8%）疾病处于病理A期，291例（92%）处于病理B期。共有45例患者（14.2%）病情进展。总体而言，28例患者（8.9%）出现局部复发，术后平均6.6年（中位时间5.5年），局部复发最晚在术后15年被发现。总体而言，25例患者（8%）在平均4.7年（中位时间6年）后出现全身进展。8例患者（2.5%）出现局部和全身衰竭。预计15年时局部和全身衰竭率分别为22%和15%。15年时疾病特异性生存率为93%，因为只有11例患者（3.4%）死于前列腺癌。在一项年龄匹配的病例对照分析中，在分析了所有预后变量（梅奥分级、 Gleason评分、包膜侵犯、病灶数量、肿瘤体积和脱氧核糖核酸肿瘤倍体）后，进展与非二倍体脱氧核糖核酸肿瘤倍体相关（p<0.0004），通过流式细胞术测定，在出现进展的患者中有63%存在这种情况，而在未复发组中这一比例为8%。
