局部前列腺癌前列腺根除術後長期追蹤結果
-楊啟瑞, 吳錫金, 張兆祥, 黃志平, 歐晏泉, 裘坤元, 蘇重光, 陳文銘, 李建儀, 王賢祥, 楊晨洸, 程千里
中國醫藥大學附設醫院泌尿部及台中榮民總醫院泌尿外科
The long-term (10 and 15 years) survival outcome of radical prostatectomy for localized prostate cancer in Taiwanese population
Chi-rei Yang1, Hsi-chin Wu1, Chao-hsiang Chang1, Yen-chuan Ou2, Chen-li Cheng2
Department of Urology, China Medical University Hospital, Taichung, Taiwan;
Division of Urology, Department of Surgery, Taichung Veterans General Hospital;2
Taichung, Taiwan
Purpose:
Due to the lower incidence of prostate cancer in Asian countries, the number of surgical management of localized prostate cancer was limited in past three decades, Here we reported the long term follow up results of radical prostatectomy that was of performed in 1980s,1900s and early 2000s
Materials and Methods:
From Jan 1984 to March, 2005, 420 accuminate patients with localized prostate cancer underwent retropubic radical prostatectomy (rrp) in TVGH were under analysis for post operative outcome and long term follow up results. 87 % of them had followed at least 10 years or until to death. Patient’s age ranged from 42 to 79 with a mean age of 67.8. According Nccn Criteria, 144 (34%) patients were classified as low risk, 152(36%) intermediate risk and 124(30%) as high risk and very high risk. The time to progression, overall survival and disease–specific survival were calculated by using Kaplan Meier’s life-table.
Results:
The Overall 5,10 and 15 yrs survival were 94, 78 and 68%. The 5, 10 and 15 yrs PSA progression free survival were 68, 63 and 62 %. If the nodal metastasis patients was excluded the 10 years overall and progression free survival were 80% and 68.2 % respectively. .The 5, 10 and 15 yrs disease-specific survival were 97, 92 and 90%. The 10 yrs overall survival for low, intermediate and high/very high risk patients were 85, 77 and 69 % respectively (p=0.02). The 10 yrs PSA progression free survival for low, intermediate and high/very high risk patients were 94,61 and 26% (p,0.001). The 10 yrs disease specific survival for low, intermediate and high/very high risk patients were 98, 97 and 79 respectively (p<0.001).
Conclusion:
This results showed higher rate (35 to 40 %) have biochemical rate following rrp, the majority of them were high or intermediate risk group. The overall survival 10 and 15 yr survival had around 10 % higher than expected life. Every few patients died of prostate cancer following rrp in long term follow up especially for low and intermediate group) except high risk patients (20 %) and suggest future challenge of rrp for high risk group.