臨床泌尿器科62巻1号

2008年01月発行

綜説

根治的前立腺全摘除術におけるpositive surgical marginの意義

著者： 大堀理¹

所属機関： ¹東京医科大学泌尿器科

ページ範囲：P.7 - P.19

文献概要

要旨　前立腺全摘標本内のpositive surgical margin（＋SM）の頻度は，標本の処理方法で大きく異なることがある。＋SMは明らかに予後不良因子の1つだが，被膜外浸潤やGleason scoreとの関連も考慮し予後を検討しなければならない。一般に被膜膜内限局癌（pT1～2）あるいは被膜外浸潤癌（pT3a）における予後への影響が強いが，精囊浸潤やリンパ節転移では影響は少ない。早期発見に伴い尖部の＋SMが増加しており，さらなる手術手技の改善が望まれる。他の因子も考慮したうえで，＋SMが局所再発を示唆するのであれば術後の放射線療法も選択肢の1つである。

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