Whitehead E D, Huh S H, Garcia R L, Rao R, Leiter E
J Urol. 1981 Sep;126(3):366-71. doi: 10.1016/s0022-5347(17)54529-2.
A series of 32 patients with carcinoma of the prostate who underwent 125iodine interstitial irradiation to the prostate and simultaneous extraperitoneal pelvic lymphadenectomy was reviewed. The patients were segregated into 3 groups: group 1-patients with early localized low grade disease, group 2-patients with advanced localized high grade disease and group 3-patients with early localized high grade disease and those with advanced localized low grade disease. Owing to the high degree of predictability of the absence or presence of pelvic lymph node metastasis in patients in groups 1 and 2 and the morbidity associated with superficial pelvic lymphadenectomy we do not advocate this procedure in these patients. However, we advocate pelvic lymphadenectomy in patients in group 3 because of the unpredictability of lymph node metastasis. Furthermore, our data indicate that 1) the morbidity of the combined procedures is relatively low, with no patients becoming incontinent and only 12.5 per cent becoming impotent, 2) 125iodine interstitial irradiation of the prostate after transurethral prostatectomy is safer in terms of postoperative complications than is radical prostatectomy and 3) while superficial pelvic lymphadenectomy is not an innocuous procedure it generally is safe and, at times, an important diagnostic staging procedure.
回顾了32例接受前列腺125碘间质照射并同期进行腹膜外盆腔淋巴结清扫术的前列腺癌患者。患者被分为3组：第1组为早期局限性低级别疾病患者，第2组为晚期局限性高级别疾病患者，第3组为早期局限性高级别疾病患者以及晚期局限性低级别疾病患者。由于第1组和第2组患者盆腔淋巴结转移有无的预测性较高，且浅表盆腔淋巴结清扫术存在相关并发症，我们不主张对这些患者进行该手术。然而，由于淋巴结转移的不可预测性，我们主张对第3组患者进行盆腔淋巴结清扫术。此外，我们的数据表明：1）联合手术的并发症发生率相对较低，没有患者出现尿失禁，只有12.5%的患者出现阳痿；2）经尿道前列腺切除术后进行前列腺125碘间质照射，就术后并发症而言，比根治性前列腺切除术更安全；3）虽然浅表盆腔淋巴结清扫术并非无害手术，但总体来说是安全的，并且有时是一项重要的诊断分期手术。
