對超高風險的攝護腺癌病人其治療傾向：義大醫院之經驗分享
呂政昕1、李彥羲1、吳振宇1、陳毓騏1、陳忠賢1、吳俊賢1、林嘉祥1,2
1. 高雄義大醫院泌尿科
2. 高雄義守大學國際醫學教育中心
Therapeutic selection for patient with very high risk prostate cancer: A single center experience
Cheng Hsin Lu1, Chen-YuWu1, Yu-Chi Chen1, Chung-Hsien Chen1, Chun Hsien Wu 1, Victor C. Lin1, 2
1. Department of Urology, E-Da Hospital, Kaohsiung, Taiwan;
2. School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
Purpose
For patients with very high risk group, radiation therapy (RT) with or without androgen deprivation therapy (ADT) was recommended by National Comprehensive Cancer Network (NCCN) guideline. Radical prostatectomy (RP) is also an accepted treatment for this kind of situation but only with highly selected patients. We reported some factors that may be helpful in decision.
Materials and Methods
RT consisted of 50-76Grey to the prostate and seminal vesicle. Reginal lymph node (LN) was treated if LN metastasis was suspected. Pelvic lymph node dissection was done in all RP patients. Medical records of patients were reviewed and age, Adult comorbidity score, PSA, biopsy Gleason score and cT stage were diagnosed.
Results
We retrospectively collected the data from 2006 to 2016. From 1235 patients diagnosed with prostate cancer, 77 were identified with very high risk prostate cancer and underwent radical prostatectomy. Another 21 patients in very high risk group received initial radiation therapy. The mean follow up durations were 3.7 and 3.9 in RP and RT group. ADT was administered in 62% and 80% of the patients receiving RP and RT. Younger patients with less comorbidity area prone to received RP. But for the overall survival has no significant difference was found between these two groups.
Conclusions
Men with very high risk prostate cancer can be improved by both radical prostatectomy and radiation therapy.