Zincke H, Fleming T R, Furlow W L, Myers R P, Utz D C
Cancer. 1981 Apr 1;47(7):1901-10. doi: 10.1002/1097-0142(19810401)47:7<1901::aid-cncr2820470731>3.0.co;2-n.
A series of 340 patients with adenocarcinoma of the prostate treated by bilateral pelvic lymphadenectomy and radical retropubic prostatectomy was reviewed to determine the factors that influence survival and time to progression of disease. Follow-up ranged from 1-12 1/2 years. Factors evaluated were grade, stage, and bulk of tumor; influence of seminal vesical involvement and number of pelvic nodes involved; age of patient; and year of surgery. Tumor grade was the only factor related significantly to patient survival. However, grade, stage, and bulk of tumor were all significantly associated with interval between surgery and disease progression. Furthermore, in Stage C disease, seminal vesical involvement (C+) was an adverse factor for disease progression, particularly among patients with low-grade tumor. This is in contrast to the finding that, among patients with Stage D1 disease, those with seminal vesical involvement experienced more favorable survival times and times to progression of disease when compared with patients without seminal vesical involvement. Overall, patient survival compared favorably with an age-matched control group for all stages, A through D1. Patients with few pelvic nodes involved had a survival experience nearly comparable with that of an age-matched control group. This suggests that pelvic lymphadenectomy might have a therapeutic value and that patients with pelvic nodal disease only, without evidence for metastatic disease, should not be denied radical surgery. The influence of concomitant hormonal manipulation or radiotherapy (or both) on patient survival and disease progression is not conclusively answered in this report.
对340例接受双侧盆腔淋巴结清扫术和耻骨后根治性前列腺切除术治疗的前列腺腺癌患者进行了回顾性研究，以确定影响生存和疾病进展时间的因素。随访时间为1至12.5年。评估的因素包括肿瘤分级、分期和大小；精囊受累情况和盆腔淋巴结受累数量的影响；患者年龄；以及手术年份。肿瘤分级是与患者生存显著相关的唯一因素。然而，肿瘤分级、分期和大小均与手术至疾病进展的间隔时间显著相关。此外，在C期疾病中，精囊受累（C+）是疾病进展的不利因素，尤其是在低级别肿瘤患者中。这与以下发现形成对比：在D1期疾病患者中，与未发生精囊受累的患者相比，发生精囊受累的患者生存时间和疾病进展时间更有利。总体而言，所有分期（A至D1）患者的生存率与年龄匹配的对照组相比良好。盆腔淋巴结受累较少的患者的生存情况与年龄匹配的对照组几乎相当。这表明盆腔淋巴结清扫术可能具有治疗价值，对于仅患有盆腔淋巴结疾病且无转移疾病证据的患者，不应拒绝根治性手术。本报告并未最终解答激素治疗或放疗（或两者同时使用）对患者生存和疾病进展的影响。
