Extended experience with radical prostatectomy for clinical stage T3 prostate cancer: outcome and contemporary morbidity.
Extended experience with radical prostatectomy for clinical stage T3 prostate cancer: outcome and contemporary morbidity.
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临床 T3 期前列腺癌根治性前列腺切除术的丰富经验：结果和当代发病率。
DOI：
10.1016/s0022-5347(01)66888-5
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
H. Zincke
中科院分区：
文献类型：
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作者：
S. Lerner;M. Blute;H. Zincke
目的临床T3期前列腺癌的根治性前列腺切除术尚未被广泛接受，因为可能会导致局部肿瘤的不完全切除和淋巴结转移的高发。此外，当代发病率不详。我们报告了812例临床T3期前列腺癌患者行根治性前列腺切除术的长期结果。材料和方法在1966年至1992年间，812例临床T3期前列腺癌患者接受了根治性前列腺切除术，其中479例（60%）接受了辅助治疗。结果患者平均年龄65岁（40 ~ 78岁）。平均随访时间为4.5年（最长24年）。17%的患者处于pT2c或更低阶段，49%的患者处于pT3a至c阶段，33%的患者处于淋巴结阳性。原发肿瘤病理格里森评分在7分或以上的占62%。5年、10年和15年的粗生存率和癌症特异性生存率分别为86%、70%和51%，以及90%、80%和69%。手术发病率与临床局限性疾病（T2c或以下）患者相似。结论对临床T3期前列腺癌患者行原发性根治性前列腺切除术配合辅助治疗可获得较好的生存率和较低的治疗相关发病率。
PurposeRadical prostatectomy for clinical stage T3 prostate cancer has not been widely accepted due to the potential for incomplete excision of the local tumor and high incidence of lymph node metastases. In addition, contemporary morbidity is unknown. We report the long-term results in 812 patients with clinical stage T3 prostate cancer treated with radical prostatectomy.Materials and MethodsBetween 1966 and 1992, 812 patients with clinical stage T3 prostate cancer underwent radical prostatectomy of whom 479 (60 percent) received adjuvant therapy.ResultsMean patient age was 65 years (range 40 to 78). Mean followup was 4.5 years (range up to 24). Disease was stage pT2c or less in 17 percent of patients, pT3a to c in 49 percent and node-positive in 33 percent. Of the primary tumors pathological Gleason score was 7 or greater in 62 percent. Crude and cancer-specific survival rates at 5, 10 and 15 years were 86 percent, 70 percent and 51 percent, and 90 percent, 80 percent and 69 percent, respectively. Operative morbidity paralleled that of patients with clinically localized disease (T2c or less).ConclusionsAn excellent survival rate with low treatment related morbidity can be achieved by performing primary radical prostatectomy with adjuvant therapy in the patient with clinical stage T3 prostate cancer.