Solomon M H, McHugh T A, Dorr R P, Lee F, Siders D B
Department of Urology, Catherine McAuley Health System, Ann Arbor, Michigan.
Clin Invest Med. 1993 Dec;16(6):532-8.
Two hundred consecutive patients with presumed localized prostate cancer had radical prostatectomy alone (n = 119) or were treated for an average period of 3 months with combination therapy using the antiandrogen flutamide and one luteinizing hormone-releasing hormone (LHRH) agonist (Lupron or Zoladex). The positive margins decreased from 35.3% in the group undergoing prostatectomy alone to 11.5% in the group of men who received combination therapy before radical prostatectomy. In 41 apical tumors, the incidence of positive margins decreased from 50% in the control group to 18.6% in the combination therapy group. In stage C disease, the incidence of positive tumor showed a tendency to decrease with the extended duration of endocrine treatment with a rate of 37.5% after 3 months and 16.7% after 6 months. Whether the decreased incidence of positive surgical margins will all translate into prolonged survival remains to be verified by long-term follow-up of these patients. However, the initial results obtained in the present study are very encouraging.
200例疑似局限性前列腺癌患者，其中119例仅接受了根治性前列腺切除术，其余患者使用抗雄激素药物氟他胺和一种促黄体生成素释放激素（LHRH）激动剂（亮丙瑞林或戈舍瑞林）联合治疗，平均治疗3个月。切缘阳性率从单纯接受前列腺切除术组的35.3%降至在根治性前列腺切除术前行联合治疗组男性中的11.5%。在41例尖部肿瘤中，切缘阳性率从对照组的50%降至联合治疗组的18.6%。在C期疾病中，随着内分泌治疗时间延长，肿瘤阳性发生率呈下降趋势，3个月时为37.5%，6个月时为16.7%。手术切缘阳性发生率的降低是否都能转化为生存期延长，仍有待对这些患者进行长期随访验证。然而，本研究获得的初步结果非常令人鼓舞。
