Rohner S, Graber P
Département de Chirurgie, Hôpital Cantonal Universitaire, Genève.
Praxis (Bern 1994). 1997 Oct 29;86(44):1730-3.
Prostate cancer is the most common malignancy and represents the second leading cause of cancer death in men of western countries. Mortality of this tumor is particularly high beyond ten years. For patients with more than 10 years of life expectancy, curative treatment, if available, is mandatory. For the others, observation and differed hormonal palliative treatment is a reasonable alternative. Radical prostatectomy is the gold standard for treatment of clinically localized prostatic cancer. Cure rate is very high when the tumor histologically is strictly confined to the prostate. Morbidity has been reduced with the development of the anatomical approach. Our experience suggests that this reduced morbidity can also be achieved in urology clinics with relatively low recruitment. In addition, our results show that chances for cure are still very high for tumors reaching or even penetrating the prostatic capsule, as long as the seminal vesicles are not invaded. Early screening of the Prostate diagnoses a vast majority of tumors before the stage of seminal vesicle invasion. Early screening may thus be recommended for patients with 10 years or more of life expectancy.
前列腺癌是最常见的恶性肿瘤，是西方国家男性癌症死亡的第二大主要原因。该肿瘤在十年后的死亡率尤其高。对于预期寿命超过10年的患者，若有治愈性治疗方法，则必须采用。对于其他患者，观察和延迟激素姑息治疗是合理的选择。根治性前列腺切除术是临床局限性前列腺癌治疗的金标准。当肿瘤在组织学上严格局限于前列腺时，治愈率非常高。随着解剖学手术方法的发展，发病率已有所降低。我们的经验表明，在招募患者相对较少的泌尿外科诊所也能实现这种发病率的降低。此外，我们的结果表明，只要精囊未受侵犯，对于到达甚至穿透前列腺包膜的肿瘤，治愈的机会仍然很高。早期前列腺筛查可在精囊受侵阶段之前诊断出绝大多数肿瘤。因此，对于预期寿命为10年或更长的患者，建议进行早期筛查。
