López López C, Quilez Fenoll J M, Gómez Ruiz J J, López López A F, Romero Maroto Y J
Servicio de Urología, Hospital Universitario San Juan, Alicante, España.
Arch Esp Urol. 1996 Oct;49(8):819-23.
To determine the usefulness of preoperative hormone therapy in patients with organ-confined prostatic carcinoma undergoing radical prostatectomy.
7 patients with localized prostatic carcinoma are presented. All patients were submitted to radical prostatectomy; 4 had been randomly selected for preoperative hormone therapy.
Histological examination showed no nodal involvement in all cases. The tumor could not be identified (Po) in two of the four patients who received hormone therapy. The other two patients were staged down; the Gleason score remained unchanged in one and increased in the other. The patients who did not receive preoperative hormone therapy showed concordant clinical and pathological stages, except one in whom infiltration of the prostatic capsule was observed. No difference was found concerning the facility in performing surgery between the treated and untreated patients.
Hormonal deprivation eliminated the tumor burden in two cases that might have been completely hormone sensitive, with no correlation in the pretreatment histological grade. Clinical downstaging is achieved by this treatment modality. However, further studies in larger series comparing the percentages of downstaging, histological downgrading, absence of tumor cells in the surgical specimen and impact on survivorship are warranted.
确定术前激素治疗对接受根治性前列腺切除术的器官局限性前列腺癌患者的有效性。
报告7例局限性前列腺癌患者。所有患者均接受了根治性前列腺切除术；其中4例被随机选择接受术前激素治疗。
组织学检查显示所有病例均无淋巴结受累。在接受激素治疗的4例患者中，有2例未发现肿瘤（P0）。另外2例患者分期降低；其中1例患者的Gleason评分保持不变，另1例升高。未接受术前激素治疗的患者临床和病理分期一致，但有1例观察到前列腺包膜浸润。在接受治疗和未接受治疗的患者之间，手术操作的难易程度没有差异。
激素剥夺消除了2例可能对激素完全敏感的患者的肿瘤负荷，与治疗前的组织学分级无关。通过这种治疗方式可实现临床分期降低。然而，有必要进行更大样本量的进一步研究，比较分期降低的百分比、组织学降级、手术标本中无肿瘤细胞的情况以及对生存率的影响。
