Stage D前立腺癌における予後因子の検討

Prognostic factors in patients with stage D prostate cancer

　1987年1月からの21年間において，藤沢市民病院で初診時にStage D前立腺癌と診断された症例166例を対象とし，予後の因子となり得るものを検討した。平均年齢71.48歳（50～91歳），観察期間は中央値30.8か月（1～119か月）であった。Gleason score別，再燃までの期間を1年で分けた場合の疾患特異的生存率，全生存率で有意差を認めた。内分泌療法によるPSA nadir値を4.0で分けた場合のPSA非再発率，疾患特異的生存率，全生存率でも有意差を認めた。化学療法（IFAP，CAP）施行の有無で分けた全生存率において有意差を認め，内分泌療法に化学療法を追加することにより予後が改善する可能性のあることが示唆された。

We retrospectively analyzed 166 patients with newly diagnosed stage D prostate cancer who had been treated in our hospital between 1987 and 2007 to evaluate factor of prognosis. Their mean age was 71.48（50～91）years with median follow up of 30.8（1～119）months. There were differences in over all survival and disease specific survival depending on gleason score and the time to hormone refractory prostate cancer. Differences were also found in biochemical failure-free rate,over all survival and disease specific survival depending whether or not PSA nadir level at least 4.0 or less was attained after androgen deprivation therapy.

A significant difference was calculated in overall survival between chemotherapy（IFAP or CAP）performed and without chemothrapy. This result suggests systemic androgen deprivation chemotherapy in proves prognosis of stage D prostate cancer.