Zincke H, Utz D C, Myers R P, Farrow G M, Patterson D E, Furlow W L
Urology. 1982 Mar;19(3):238-47. doi: 10.1016/0090-4295(82)90491-5.
Ninety-nine patients with adenocarcinoma of the prostate and regional lymph node involvement underwent pelvic lymphadenectomy. Therapeutic results were analyzed in 70 patients who subsequently underwent radical retropubic prostatectomy with or without concomitant therapy (usually hormonal) and in 29 patients who received radiation or hormonal treatment only but without prostatectomy. Follow-up ranged from one to fourteen and one-half years. The over-all projected survival rates (Kaplan-Meier) at five and ten years (88 per cent and 71 per cent, respectively) in the prostatectomy series were comparable to those of an age-matched control group. Concomitant bilateral orchiectomy provided a high projected (76 per cent at ten years) nonprogression rate. Over-all survival rates in the nonprostatectomy series were poor. Only the number of nodes involved was associated with survival and time to disease progression. Patient age, tumor bulk, seminal vesicle involvement, and tumor grade (Mayo and Gleason scores) had no definite relationship to survival. Pelvic lymphadenectomy and radical retropubic prostatectomy for prostatic adenocarcinoma may be therapeutic in some patients with limited (less than or equal to two positive nodes) nodal disease.
99例患有前列腺腺癌并伴有区域淋巴结受累的患者接受了盆腔淋巴结清扫术。对70例随后接受耻骨后前列腺根治术（无论是否同时进行治疗，通常为激素治疗）的患者以及29例仅接受放疗或激素治疗但未进行前列腺切除术的患者的治疗结果进行了分析。随访时间为1至14.5年。前列腺切除术组5年和10年的总体预计生存率（Kaplan-Meier法）（分别为88%和71%）与年龄匹配的对照组相当。同时进行双侧睾丸切除术可提供较高的预计无进展率（10年时为76%）。非前列腺切除术组的总体生存率较差。仅受累淋巴结的数量与生存率和疾病进展时间相关。患者年龄、肿瘤大小、精囊受累情况以及肿瘤分级（梅奥和格里森评分）与生存率无明确关系。对于一些淋巴结疾病有限（小于或等于两个阳性淋巴结）的前列腺腺癌患者，盆腔淋巴结清扫术和耻骨后前列腺根治术可能具有治疗作用。
