単一施設における限局性前立腺癌に対する内分泌単独療法の臨床的検討

Clinical study of hormonal monotherapy for localized prostate cancer at a single center

　1999年から2008年までに大垣市民病院にて限局性前立腺癌として内分泌単独療法を施行した345症例を臨床的に検討した。5年全生存率は81.9％，5年癌特異的生存率は97.6％，5年非再燃率は94％であった。D'Amicoリスク分類では，low risk group，intermediate risk group，high risk groupのそれぞれの5年癌特異的生存率は100％，100％，93.6％で，各group間に有意差は認めなかった。5年非再燃率は98.1％，98.2％，82.1％で，intermediate risk groupとhigh risk groupとの間に有意差を認めた。多変量解析にて，予後危険因子はGleason scoreのみ，再燃危険因子はGleason score，PSA nadir値，治療前PSA値の順であった。限局性前立腺癌症例の全生存率曲線は，期待生存率曲線と同様であった。

We treated 345 patients who presented with localized prostatic cancer by hormonal monotherapy at Ogaki Municipal Hospital between 1999 and 2008. The overall 5-year survival rate for localized prostatic cancer was 81.9％. The 5-year cause-specific survival rate was 97.6％. The 5-year no-relapse rate was 94％. The 5-year cause-specific survival rates of low risk,intermediate risk,and high risk group according to D'Amico risk grouping were 100％,100％,93.6％,respectively. There was not a significant difference in cause-specific survival rate between each risk group. The 5-year no-relapse rates of low risk,intermediate risk,high risk group were 98.1％,98.2％,82.1％,respectively. There was a significant difference in no-relapse rates between intermediate risk and high risk group.

　Multivariate proportional hazard analysis showed that Gleason score was independent prognostic risk factor. Gleason score,PSA nadir level and pretreatment PSA value were independent relapse risk factors. The overall survival curve for localized prostate cancer was similar to the expected survival curves for age-matched men.