Jewett H J
J Urol. 1980 Oct;124(4):492-4. doi: 10.1016/s0022-5347(17)55509-3.
Of 447 patients who underwent radical perineal prostatectomy and were examined during the 54 years of study only those with a 1 to 2 cm. nodule within an otherwise clinically normal prostate have, on the average, done well. When the current staging segregation has been used, these cases were labeled B1 or occasionally B1n, and were nearly always grade 1 or 2, although 77 per cent were diffuse microscopically within the gland. No patient with a grade 3 cancer has lived 15 years free of disease. Biopsy is mandatory for diagnosis and for eliminating grade 3 cancer. The immunochemical determination of prostatic acid phosphatase in the bone marrow, not used in these reported cases, may prove to be the most sensitive test for otherwise unrecognized osseous metastases. So far no non-invasive test is infallible in detecting micrometastases in lymph nodes but these are rare when the tumor is a 1 to 2 cm. nodule. In such cases the operation, so far, provides a 15-year survivorship better than that of any other modality.
在接受经会阴根治性前列腺切除术并在54年研究期间接受检查的447例患者中，只有那些在临床上正常的前列腺内有1至2厘米结节的患者，总体情况良好。当采用当前的分期分类时，这些病例被归类为B1期，偶尔为B1n期，几乎均为1级或2级，尽管77%在显微镜下呈弥漫性分布于腺体内。没有3级癌症患者能无病存活15年。活检对于诊断和排除3级癌症是必需的。骨髓中前列腺酸性磷酸酶的免疫化学测定（在这些报告的病例中未使用）可能被证明是检测未被识别的骨转移最敏感的试验。到目前为止，没有任何非侵入性检查能绝对可靠地检测出淋巴结中的微转移，但当肿瘤为1至2厘米结节时，这种情况很少见。到目前为止，在这种情况下，手术提供的15年生存率比任何其他治疗方式都要好。
