Elder J S, Jewett H J, Walsh P C
J Urol. 1982 Apr;127(4):704-6. doi: 10.1016/s0022-5347(17)54005-7.
To refine the criteria for radical surgery in clinical stage B2 prostatic cancer a retrospective study was made of 53 patients who underwent radical perineal prostatectomy between 1951 and 1963. The 15-year survival free of tumor was 25 per cent, significantly less than the 51 per cent survival rate in a series of patients with clinical B1 disease undergoing radical perineal prostatectomy during the same period. Sixty-six per cent of the patients had extraprostatic extension of tumor on histological examination. The 15-year survival free of tumor in these patients was only 13 per cent, whereas those patients with tumor histologically confined to the prostate had a 15-year survival rate of 50 per cent, equal to an age-matched control population. Thus, although prolonged survival was demonstrated in patients without extraprostatic extension only a third of all clinical B2 cases were in this favorable category. Consequently, until improved reliable techniques for detection of extraprostatic extension become available it seems unwise to recommend radical prostatectomy as the treatment of choice for all men with clinical stage B2 disease.
为完善临床B2期前列腺癌根治性手术的标准，对1951年至1963年间接受经会阴前列腺根治性切除术的53例患者进行了回顾性研究。无瘤生存15年的比例为25%，显著低于同期接受经会阴前列腺根治性切除术的一系列临床B1期患者51%的生存率。66%的患者在组织学检查时有肿瘤前列腺外侵犯。这些患者无瘤生存15年的比例仅为13%，而肿瘤组织学上局限于前列腺的患者15年生存率为50%，与年龄匹配的对照人群相当。因此，尽管在无前列腺外侵犯的患者中显示出较长的生存期，但所有临床B2期病例中只有三分之一属于这一有利类别。因此，在获得用于检测前列腺外侵犯的更可靠技术之前，推荐将前列腺根治性切除术作为所有临床B2期男性患者的首选治疗方法似乎是不明智的。
