Frohmüller H G, Theiss M
Department of Urology, University of Würzburg, School of Medicine, Germany.
Eur J Surg Oncol. 1995 Aug;21(4):336-40. doi: 10.1016/s0748-7983(95)92120-6.
No data from prospective randomized studies comparing radical prostatectomy, radiotherapy and deferred treatment for localized prostatic cancer are currently available. Comparison of retrospective series, however, strongly suggests a clear superiority of radical prostatectomy over other attempts to cure prostate cancer, and especially over the 'watchful waiting' strategy. This concerns survival data as well as quality of life and psychological aspects. In 1994, the Department of Veterans Affairs and The National Cancer Institute in the United States initiated a randomized controlled study comparing radical prostatectomy vs expectant management for the treatment of localized prostate cancer, the 'Prostate Cancer Intervention vs Observation Trial (PIVOT)'. Until the results of this study become available, the decision on how to manage a patient with a newly-diagnosed clinically localized prostate cancer has to be based on current knowledge. The current knowledge is that localized prostate cancer can be cured by radical prostatectomy with acceptable treatment-related morbidity. Therefore, the chance of receiving curative treatment should be offered to every man with localized prostate cancer and a life expectancy of 10 or more years.
目前尚无前瞻性随机研究比较根治性前列腺切除术、放射治疗和对局限性前列腺癌进行延迟治疗的数据。然而，回顾性系列研究的比较强烈表明，根治性前列腺切除术明显优于其他治疗前列腺癌的方法，尤其是优于“观察等待”策略。这涉及生存数据以及生活质量和心理方面。1994年，美国退伍军人事务部和国家癌症研究所发起了一项随机对照研究，比较根治性前列腺切除术与期待性治疗对局限性前列腺癌的疗效，即“前列腺癌干预与观察试验（PIVOT）”。在该研究结果出来之前，对于如何治疗新诊断的临床局限性前列腺癌患者的决策必须基于当前的知识。当前的知识是，局限性前列腺癌可通过根治性前列腺切除术治愈，且治疗相关的发病率可接受。因此，对于每一位患有局限性前列腺癌且预期寿命为10年或更长的男性，都应提供接受根治性治疗的机会。
