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Interstitial radiation therapy for carcinoma of the prostate
Author(s) -
Whitmore Willet F.
Publication year - 1980
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.2990010203
Subject(s) - medicine , stage (stratigraphy) , metastasis , radiation therapy , dissection (medical) , carcinoma , cancer , lymph node , surgery , survival rate , oncology , paleontology , biology
Pelvic lymph node dissection and iodine 125 implantation has been systematically utilized at Memorial Sloan‐Kettering Cancer Center (MSKCC) since 1970 as one form of management of selected patients with stage B or stage C prostatic cancer. Experience with the technique is reviewed on the basis of previously published data and on the basis of a five‐year follow‐up of the first 100 patients. The operative procedure has been generally well tolerated, with a low morbidity, with a mortality rate of 0.67% (2/300), and with minimal adverse effects on urinary, rectal, and sexual functions. Thirty‐six percent of the patients had regional lymph node metastasis, and such was associated with a 71% incidence of distant metastasis at five years. However, at five years 14% of patients with positive nodes remain free of evidence of neoplasm, and 38% of patients with negative lymph nodes have evidence of bone metastasis. At five years, 11% of patients have evidence of local recurrence only; 19%, distant metastasis only; and 32%, both local recurrence and distant metastasis. Five‐year survival without stratification relative to lymph node involvement is 100% (16/16) for stage B 1 , 88% (23/26) for stage B 2 , 66% (6/10) for stage B 3 , 33% (2/6) for stage C 1 , 53% (17/32) for stage C 2 , and 1/1 for stage C 3 , but endocrine therapy has presumably contributed to such survival in those patients developing intractable local recurrence and/or symptomatic distant metastasis within the five‐year follow‐up.