The present status of radical prostatectomy for stages A and B prostatic cancer.
The present status of radical prostatectomy for stages A and B prostatic cancer.
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A 期和 B 期前列腺癌根治性前列腺切除术的现状。
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发表时间：
1975
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影响因子：
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通讯作者：
Jewett Hj
中科院分区：
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作者：
Jewett Hj
前列腺癌的自然病程还不完全清楚。小的癌症可能有一个非常缓慢或快速的生长速度，大多数是分化的。细胞可以通过血液或淋巴液离开前列腺，而不穿透包膜或侵入精囊。在任何给定的情况下，潜伏期或生物活性的预测是不可能的。A期癌症应分为A1（局灶性）和A2（弥漫性）。A1期低级别癌症最好单独治疗。A2期癌症和高级别癌症可能应该用兆伏辐射治疗。B期包括许多在显微镜下为C期的癌症。如果将这一阶段分为临床阶段B1（肿瘤严重累及少于一个肺叶）和B2（肿瘤累及一个或多个肺叶），则B1中显微镜范围的低估将小于10%的病例。在临床阶段B2的癌症中，50%在显微镜下为C期。根治性前列腺切除术应仅限于临床B1病例，而不会远处扩散。它不是一个包治百病，但它提供了最好的15年生存率更完全，更快，更便宜，更少的不适比其他方法。替代方案是不治疗、内分泌治疗和放射治疗。第一种方法在许多情况下是危险的，可能会使活性癌症失去控制。第二种方法很少破坏整个细胞群中的所有细胞，并给人一种虚假的安全感。最后一个应该保留的情况下远远超过B1期，但没有远处转移，其有用性超过根治性切除。
: The natural history of prostatic cancer is incompletely understood. Small cancers may have a very slow or rapid growthrate, and the majority are differentiated. Cells may leave the prostate by blood or lymph without penetrating capsule or invading the seminal vesicles. The predication of latency or of biologic activity in any givne case is impossible. Stage A cancer should be separated into A1 (focal) and A2 (diffuse). Stage A1 cancer that is low grade is best lfet alone. Stage A2 cancer and high grade cancer probably should be treated by megavoltage radiation. Stage B includes many cancers that are microscopically stage C. If this stage is separated into clinical stage B1 (tumors grossly involving less than one lobe), and B2 (tumors involving one lobe or more) the underestimation of microscopic extent in B1 will be less than in 10 per cent of the cases. In clinical stage B2 cancer, 50 per cent are microscopically stage C. Radical prostatectomy for cure should be limited to clinical B1 cases without distant spread. It is not a cure-all, but it provides the best 15-year survival rate more completely, more quickly, less expensively, and with fewer discomforts than other methods. The alternative options are no treatment, endocrine treatment, and radiation. The first is risky in many instances and may allow an ac-ive cancer to get out of control. The second rarely destroys all of the cells in the total cell population and gives one a false sense of security. The last should be reserved for cases well beyond stage B1, but without distant metastases, where its usefulness exceeds that of radical excision.