Carey P O, Lippert M C, Constable W C, Jones D, Talton B M
Department of Urology, University of Virginia Medical School, Charlottesville.
J Urol. 1988 May;139(5):989-94. doi: 10.1016/s0022-5347(17)42740-6.
Patients with clinical stage B2 or C prostatic carcinoma represent a group for which there are several treatment options. We followed the course and outcome of 72 patients with clinical stages B and C prostate cancer who were treated with surgical staging, insertion of gold grains and external radiation at our institutions between 1975 and 1984. Of the patients 44 (61 per cent) had clinical stage B disease and the majority (89 per cent) of these were stage B2 lesions. The remaining 28 patients (39 per cent) had clinical stage C tumors. In our series 27 per cent of the clinical stage B and 68 per cent of the clinical stage C cancer patients had positive lymph nodes. The 5-year survival free of disease was 52 per cent for patients with both stages of disease. The 7-year survival free of disease was 47 per cent for patients with clinical stage B and 14 per cent for those with clinical stage C cancer. Lymph node status did not have a statistically significant effect on total survival but survival free of disease correlated significantly with node status. Local treatment failures were defined as patients who required transurethral prostatic resection or orchiectomy for palliation of obstructive symptoms related to local tumor regrowth. By these criteria we prevented local progression in 78 per cent of the patients at 5 years.
临床分期为B2或C期的前列腺癌患者有多种治疗选择。我们追踪了1975年至1984年间在我们机构接受手术分期、植入金粒和外照射治疗的72例临床分期为B期和C期前列腺癌患者的病程及预后。其中44例（61%）患者为临床B期疾病，其中大多数（89%）为B2期病变。其余28例患者（39%）为临床C期肿瘤。在我们的系列研究中，27%的临床B期和68%的临床C期癌症患者有阳性淋巴结。两个分期的患者5年无病生存率为52%。临床B期患者7年无病生存率为47%，临床C期癌症患者为14%。淋巴结状态对总生存率没有统计学上的显著影响，但无病生存率与淋巴结状态显著相关。局部治疗失败定义为因局部肿瘤复发引起的梗阻症状而需要经尿道前列腺切除术或睾丸切除术进行姑息治疗的患者。根据这些标准，我们在5年时防止了78%的患者出现局部进展。
