Yamada A H, Lieskovsky G, Petrovich Z, Chen S C, Groshen S, Skinner D G
Department of Urology, University of Southern California School of Medicine, Los Angeles 90033.
Am J Clin Oncol. 1994 Aug;17(4):277-85. doi: 10.1097/00000421-199408000-00001.
Fifty-seven patients with locally advanced, clinical stage TC, adenocarcinoma of the prostate underwent treatment consisting of surgery, external beam radiation therapy and, in selected patients, early hormonal ablation and/or systemic chemotherapy. Surgical morbidity from radical retropubic prostatectomy and limited pelvic lymph node dissection was acceptable with an early complication rate of 11%. Followup ranged from 3.5 to 19.9 years (median 5.4 years). Actuarial 5 and 7.5 years survival rates for all patients was 91.2% and 77.6%, respectively. Of the 57 study patients 19 (33%) were alive with no evidence of disease, including a prostate specific antigen (PSA) less than 0.4 ng/ml at all times during follow-up. The estimated 5 year probability of clinical recurrence was 18.6% and the 5 year probability of clinical and PSA recurrence (> 0.4 ng/ml) was 54.5%. Local recurrence occurred in only 3 patients. This included 2 (4%) patients who received adjuvant radiotherapy. Our results suggest that patients with locally advanced prostate cancer can be successfully treated with low morbidity using a combination of radical prostatectomy and planned adjuvant radiotherapy.
57例局部晚期临床分期为TC的前列腺腺癌患者接受了包括手术、体外照射放疗，部分患者还接受了早期激素消融和/或全身化疗的治疗。耻骨后根治性前列腺切除术和局限性盆腔淋巴结清扫术的手术并发症可接受，早期并发症发生率为11%。随访时间为3.5至19.9年（中位时间5.4年）。所有患者的精算5年和7.5年生存率分别为91.2%和77.6%。57例研究患者中，19例（33%）存活且无疾病证据，包括随访期间所有时间前列腺特异性抗原（PSA）均低于0.4 ng/ml。临床复发的估计5年概率为18.6%，临床和PSA复发（>0.4 ng/ml）的5年概率为54.5%。仅3例患者发生局部复发。其中包括2例（4%）接受辅助放疗的患者。我们的结果表明，局部晚期前列腺癌患者采用根治性前列腺切除术和计划性辅助放疗相结合的方法可以成功治疗，且并发症发生率低。
