Terris M K, Hausdorff J, Freiha F S
Department of Urology, Stanford University Medical Center, California 94305-5118, USA.
J Urol. 1997 Oct;158(4):1457-9.
The clinical impact of hematolymphoid malignancies discovered during radical prostatectomy has not been previously defined to our knowledge.
From October 1988 to September 1995, 1,092 patients underwent radical retropubic prostatectomy.
Of 1,092 radical prostatectomy specimens, 13 (1.2%) were found to have hematologic malignancies involving the prostate and/or lymph nodes sampled during concomitant pelvic lymph node dissection. The malignancies detected included Hodgkin's disease (3) and hairy cell leukemia (1), which required further therapy. However, 9 of the 13 patients (62%) demonstrated either chronic lymphocytic leukemia (3) or low grade, small lymphocytic lymphoma (6), which requires symptomatic treatment only. The transrectal ultrasound guided prostate biopsies revealed suspicious lymphocytic infiltrate in addition to prostatic adenocarcinoma in 2 of the 13 patients (15%).
The majority of hematologic malignancies discovered at radical prostatectomy do not require further treatment and should not delay treatment of prostatic adenocarcinoma.
据我们所知,根治性前列腺切除术中发现的血液淋巴系统恶性肿瘤的临床影响此前尚未明确。
1988年10月至1995年9月,1092例患者接受了根治性耻骨后前列腺切除术。
在1092份根治性前列腺切除标本中,13份(1.2%)被发现存在血液系统恶性肿瘤,累及前列腺和/或在同期盆腔淋巴结清扫术中取样的淋巴结。检测到的恶性肿瘤包括霍奇金病(3例)和毛细胞白血病(1例),这些需要进一步治疗。然而,13例患者中有9例(62%)表现为慢性淋巴细胞白血病(3例)或低级别小淋巴细胞淋巴瘤(6例),仅需对症治疗。经直肠超声引导下前列腺活检显示,13例患者中有2例(15%)除前列腺腺癌外还存在可疑淋巴细胞浸润。
根治性前列腺切除术中发现的大多数血液系统恶性肿瘤无需进一步治疗,也不应延误前列腺腺癌的治疗。