Mack D, Jungwirth A, Adam U, Kunit G, Miller K, Dietze O, Frick J
Department of Urology, Salzburg General Hospital, Austria.
Eur Urol. 1997;32(2):129-32.
Appropriate therapies for locally confined adenocarcinoma of the prostate are available-but there is as yet no gold standard of therapy. For that reason, old therapeutic regimens are being revised. One such regimen is cryotherapy.
Between 1976 and 1989, 1,250 patients were seen with newly diagnosed prostate cancer. Sixty-six patients of stages T1c (n = 3), T2a (n = 32), T2b (n = 9), T2c (n = 11), T3a (n = 4), T3b (n = 5) and T3c (n = 2) were treated by open perineal cryotherapy. Mean age was 68 years. Three months after surgery, transurethral resection of the prostate and/or perineal biopsy was performed.
In 66% of patients with stages T1c-T2b and in 87% of patients with stages T2c-T3c, positive biopsies were obtained. To date, 28 patients have died between 3 and 16 years after cryotherapy, with a mean survival of 7.2 years. The mean follow-up period of survivors (38 patients) is 8.5 years. Complications were: stress-incontinence in 10%, impotence in 10% and temporary rectoperineal fistula in 8%.
Cryosurgery is an effective treatment for locally confined prostate cancer. With improvement of the procedure, clinical outcome may also improve.
针对局限性前列腺腺癌已有多种合适的治疗方法，但尚无治疗的金标准。因此，旧的治疗方案正在修订。冷冻疗法就是其中一种方案。
1976年至1989年间，共诊治了1250例新诊断的前列腺癌患者。其中66例T1c期（n = 3）、T2a期（n = 32）、T2b期（n = 9）、T2c期（n = 11）、T3a期（n = 4）、T3b期（n = 5）和T3c期（n = 2）的患者接受了开放性经会阴冷冻治疗。平均年龄为68岁。术后三个月，进行经尿道前列腺切除术和/或会阴活检。
T1c - T2b期患者中66%以及T2c - T3c期患者中87%的活检结果为阳性。迄今为止，28例患者在冷冻治疗后3至16年死亡，平均生存期为7.2年。存活的38例患者的平均随访期为8.5年。并发症包括：压力性尿失禁10%、阳痿10%、暂时性直肠会阴瘘8%。
冷冻手术是局限性前列腺癌的一种有效治疗方法。随着手术方法的改进，临床疗效可能也会提高。
