前立腺癌に対する内分泌治療の有効性と予後因子に関する検討

元データ 学校法人 昭和大学・昭和医学会

概要

A retrospective review of patients with prostate cancer was performed to evaluate the efficacy of primary hormonal therapy and predict long-term prognosis in these patients. Between 1988 and 2005, a total of 692 patients who were diagnosed with prostate cancer in clinical stages A to D were treated with primary hormonal therapy at Showa University Hospital and National Disaster Medical Center. The clinical outcome of the patients was analyzed in relation to clinical stage, biopsy Gleason score, pretreatment PSA, and % positive core. The median age of patients was 76 years (range 50-97), and the median follow-up period was 886 days (range 10-5812 days) and median pretreatment PSA level was 31 ng/ml (range 0.7218000) . The 5 and 10-year overall survival rates of all 692 patients were 70.7% and 51.6%, respectively, with 5 and 10-year cause-specific survival rates of 82.9% and 68.3% respectively. The 5 and 10-year PSA failure-free survival rates of all patients were 61.9% and 38.8% respectively. In the Kaplan-Meire method, between all or some categories investigated showed significant difference in prognosis. In multivariate analysis, the factors that significantly affected prognosis were the clinical stage, Gleason score, % positive core. It is possible to show nomograms to patients to predict the 5-year causespecific survival rate. In conclusion, our results show that hormonal therapy had a good long-term outcome in early stage cancer, and the % positive core was an independent prognostic factor. These results are useful in explaining the status or future prospective of the disease to patients and families.

著者

永田 将一 昭和大学横浜市北部病院泌尿器科
深貝 隆志 昭和大学医学部泌尿器科学
森田 順 昭和大学医学部泌尿器科学
永田 将一 昭和大学医学部泌尿器科学
首藤 直樹 昭和大学医学部泌尿器科学教室
吉田 英機 昭和大学医学部泌尿器科
檜垣 昌夫 独立行政法人国立病院機構災害医療センター泌尿器科
鈴木 康太 昭和大学医学部泌尿器科
石原 理裕 独立行政法人国立病院機構災害医療センター泌尿器科
五十嵐 敦 独立行政法人国立病院機構災害医療センター泌尿器科
森田 順 昭和大学泌尿器科
石原 理裕 独立行政法人国立病院機構災害医療センター
森田 将 昭和大学医学部泌尿器科

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