経尿道的前立腺切除術によって発見された前立腺偶発癌(A癌)の臨床的検討

概要

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Transurethral resection of the prostate was performed on 584 consecutive patients with clinically diagnosed benign prostatic hyperplasia between April 2001 and July 2007. Pathological examinations revealed prostatic cancer in 30 (5.1%) of them. Seventeen patients had stage A1, and 13 stage A2 cancer. Prostatic biopsy was performed on 7 patients. The mean patient age was 69.4 years (range 60-78 years) for stage A1 cancer and 76.6 years (range 62-90 years) for stage A2. The mean serum PSA concentration was 8.9 ng/ml (range 1.18-41.3 ng/ml) for stage A1 cancer and 9.55 ng/ml (range 2.0-23.9 ng/ml) for stage A2. The mean follow-up period was 25.8 months (range 3-82 months) for stage A1 cancer and 27.3 months (range 1-82 months) for stage A2. In stage A1, all patients had a Gleason sum of 6 or less. In stage A2, 11 patients had a Gleason sum of 7 and 2 patients were 8 or more. Total prostatectomy was performed on 2 patients and no therapy on 15 patients with stage A1. Endocrine therapy was given to 1 patient, radiation therapy to 1 patient and no therapy to 11 patients with stage A2. Adjuvant therapy was given to 2 patients with stage A1 and to no one with stage A2. We concluded that PSA monitoring is an option in stage A2 cancer.
泌尿器科紀要刊行会の論文