Yamashita A, Hayashi N, Sugimura Y, Yanagawa M, Arima K, Nakano S, Kimbara H, Tochigi H, Kawamura J
Department of Urology, Mie University School of Medicine.
Hinyokika Kiyo. 1995 Jun;41(6):447-53.
One hundred and eighty-four patients with prostatic cancer were treated at Mie University Hospital from 1973 to 1993. They were between 47 and 90 years old, with an average age of 71.8 years old. One hundred and fifty-eight patients (85.8%) were in either stage C or D. Of the 146 cases histologically examined, 17.8% were well differentiated adenocarcinoma, and 47.9% and 34.2% were moderately and poorly differentiated adenocarcinomas, respectively. The overall 3-year, 5-year and 10-year survival rate were 64.2%, 44.9% and 24.2%, respectively. The patients with high stage and/or poorly differentiated adenocarcinomas revealed worse prognosis. Although the prognosis in the patients treated with estrogen and orchiectomy was better than that with estrogen alone, there was no significant difference between the 2 treatment groups. The prognosis of patients with prostatic cancer has been improved since 1988. A possible explanation is that prostate specific antigen has been introduced as a tumor marker, which might contribute to an accurate diagnosis in prostatic cancer and improve the prognosis of the disease. In conclusion, the diagnosis in lower stage and radical prostatectomy might bring favorable prognosis. In future, safer and more effective chemotherapy and endocrine therapy including LH-RH analogue are awaited, to obtain a better prognosis in the patients with advanced prostatic cancer.
1973年至1993年期间,184例前列腺癌患者在三重大学医院接受治疗。他们的年龄在47岁至90岁之间,平均年龄为71.8岁。158例患者(85.8%)处于C期或D期。在146例接受组织学检查的病例中,高分化腺癌占17.8%,中分化腺癌和低分化腺癌分别占47.9%和34.2%。总体3年、5年和10年生存率分别为64.2%、44.9%和24.2%。高分期和/或低分化腺癌患者的预后较差。虽然接受雌激素和睾丸切除术治疗的患者预后优于单纯接受雌激素治疗的患者,但两个治疗组之间没有显著差异。自1988年以来,前列腺癌患者的预后有所改善。一种可能的解释是,前列腺特异性抗原已被用作肿瘤标志物,这可能有助于前列腺癌的准确诊断并改善疾病的预后。总之,低分期诊断和根治性前列腺切除术可能带来良好的预后。未来,期待更安全、更有效的化疗和包括促性腺激素释放激素类似物在内的内分泌治疗,以改善晚期前列腺癌患者的预后。