Results of radical prostatectomy in men with clinically localized prostate cancer.

Results of radical prostatectomy in men with clinically localized prostate cancer.
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临床局限性前列腺癌男性根治性前列腺切除术的结果。

DOI：
10.1001/jama.1996.03540080037026
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发表时间：
1996
期刊：
JAMA
影响因子：
--
通讯作者：
G. Chodak
G. Chodak
中科院分区：
--
文献类型：
--
作者：
G. Gerber;R. Thisted;P. Scardino;H. Frohmuller;F. Schroeder;D. Paulson;A. W. Middleton;D. Rukstalis;Joseph A. Smith;P. Schellhammer;M. Ohori;G. Chodak

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目的 目的探讨早期前列腺癌根治术的疗效。 设计 回顾性、非随机、多机构汇总分析。 设置 美国和欧洲的八所大学医学中心。 患者 总计2758名患有T1和T2期前列腺癌的男性。 主要观察指标 疾病特异性和无转移生存率。 结果 肿瘤分级是决定预后的最重要的术前因素。对于1级、2级和3级肿瘤患者，手术后10年疾病特异性生存率和相关的95%置信区间分别为94%（范围，87%-98%）、80%（范围，74%-85%）和77%（范围，65%-86%）。对于1级、2级和3级癌症患者，10年无转移生存率分别为87%（范围，78%-92%）、68%（范围，62%-73%）和52%（范围，38%-64%）。 结论 根治性直肠癌切除术导致所有肿瘤分级的男性的高10年疾病特异性生存率。然而，由于非对照试验中固有的潜在偏倚，在将这些结果与替代治疗策略（如观察等待）的类似研究进行比较时需要谨慎。尽管如此，这些结果提供了目前最好的估计10年的结果根治性前列腺切除术的男性临床局限性前列腺癌，并可能是有用的咨询患者早期恶性肿瘤。
OBJECTIVE To assess the results of radical prostatectomy in men with early prostate cancer. DESIGN Retrospective, nonrandomized, multi-institutional pooled analysis. SETTING Eight university medical centers in the United States and Europe. PATIENTS A total of 2758 men with stage Tl and T2 prostatic cancer. MAIN OUTCOME MEASURES Disease-specific and metastasis-free survival rates. RESULTS Tumor grade was the most important preoperative factor in determining outcome. Disease-specific survival 10 years following surgery and associated 95% confidence intervals were 94% (range, 87%-98%), 80% (range, 74%-85%), and 77% (range, 65%-86%) for those men with grade 1, 2, and 3 tumors, respectively. Metastasis-free survival at 10 years was 87% (range, 78%-92%), 68% (range, 62%-73%), and 52% (range, 38%-64%) for patients with grade 1, 2, and 3 cancers, respectively. CONCLUSIONS Radical prostatectomy leads to high 10-year disease-specific survival rates in men with all tumor grades. However, caution is needed in comparing these results with similar studies of alternative treatment strategies, such as watchful waiting, due to the inherent potential biases in uncontrolled trials. Nevertheless, these results offer the best currently available estimates of 10-year outcome of radical prostatectomy in men with clinically localized prostate cancer and may be useful in counseling patients with early malignancy.