臨床泌尿器科76巻11号

2022年10月発行

特集 限局性前立腺癌診療バイブル―このへんでキッチリと前立腺癌診療の“あたりまえ”を整理しよう！ 〈高齢者・その他〉

高齢者限局性前立腺癌治療

著者： 成田伸太郎¹

所属機関： ¹秋田大学大学院医学系研究科腎泌尿器科学講座

ページ範囲：P.844 - P.850

▶ポイント

・高齢者は多様で個別的な診断・治療戦略が必要である．

・監視療法および待機療法は高齢者限局性前立腺癌において重要な選択肢となる．

・手術療法および放射線治療の成績はおおむね良好で，適切な症例を選択すれば有効な選択肢である．

参考文献

1） Droz JP, et al : Background for the Proposal of SIOG Guidelines for the Management of Prostate Cancer in Senior Adults. Crit Rev Oncol Hematol 73 : 68-91, 2010

2） Boyle HJ, et al : Updated Recommendations of the International Society of Geriatric Oncology on Prostate Cancer Management in Older Patients. Eur J Cancer 116 : 116-136, 2019

3） Droz JP, et al : Management of Prostate Cancer in Older Men : Recommendations of a Working Group of the International Society of Geriatric Oncology. BJU Int 106 : 462-469, 2010

4） Droz JP, et al : Management of Prostate Cancer in Older Patients : Updated Recommendations of a Working Group of the International Society of Geriatric Oncology. Lancet Oncol 15 : e404-414, 2014

5） Gershman B, et al : Impact of Prostate-specific Antigen （PSA） Screening Trials and Revised PSA Screening Guidelines on Rates of Prostate Biopsy and Postbiopsy Complications. Eur Urol 71 : 55-65, 2017

6） de Carvalho TM, et al : Screening for Prostate Cancer in the US? Reduce the Harms and Keep the Benefit. Int J Cancer 136 : 1600-1607, 2015

7） American Urological Association : Prostate Cancer Guidelines.　https://www.auanet.org/guidelines-and-quality/guidelines/oncology-guidelines/prostate-cancer （2022年8月1日閲覧）

8） European Association of Urology : EAU Guideline for Prostate Cancer.　https://uroweb.org/guideline/prostate-cancer/ （2022年8月1日閲覧）

9） Rider JR, et al : Long-Term Outcomes Among Noncuratively Treated Men According to Prostate Cancer Risk Category in a Nationwide, Population-Based Study. Eur Urol 63 : 88-96, 2013

10） Hamdy FC, et al : 10-Year Outcomes After Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med 375 : 1415-1424, 2016

11） Verduzco-Aguirre HC, et al : Predicting Life Expectancy for Older Adults with Cancer in Clinical Practice : Implications for Shared Decision-making. Curr Oncol Rep 21 : 68, 2019

12） McClymont KM, et al : Usefulness and Effect of Online Prognostic Calculators. J Am Geriatr Soc 62 : 2444-2445, 2014

13） Gurung PMS, et al : Oncological and Functional Outcomes in Patients over 70 Years of Age Treated with Robotic Radical Prostatectomy : A Propensity-Matched Analysis. World J Urol 39 : 1131-1140, 2021

14） Traboulsi SL, et al : Functional and Perioperative Outcomes in Elderly Men After Robotic-Assisted Radical Prostatectomy for Prostate Cancer. World J Urol 38 : 2791-2798, 2020

15） Mandel P, et al : Radical Prostatectomy in Patients Aged 75 Years or Older : Review of the Literature. Asian J Androl 21 : 32-36, 2017

16） Iguchi K, et al : Characteristics of Urodynamic Study Parameters Associated with Intermediate-Term Continence After Robot-Assisted Radical Prostatectomy in Elderly Patients. Aging Male 23 : 1039-1045, 2020

17） Togashi K, et al : Oncologic and Patient-Reported Outcomes After Robot-Assisted Radical Prostatectomy in Men Aged ≥ 75 Years. Urol Oncol 39 : 729.e17-729.e25, 2020

18） Yamada Y, et al : Comparison of Perioperative Outcomes in Elderly （Age ≧ 75 Years） vs. Younger Men Undergoing Robot-Assisted Radical Prostatectomy. PLoS One 15 : e0234113, 2020

19） Lardas M, et al : Patient- and Tumour-Related Prognostic Factors for Urinary Incontinence After Radical Prostatectomy for Nonmetastatic Prostate Cancer : A Systematic Review and Meta-analysis. Eur Urol Focus S2405-4569 : 00126-00127, 2021

20） Dell'Oglio P, et al : Long-Term Survival of Patients Aged 80 Years or Older Treated with Radical Prostatectomy for Prostate Cancer. Eur J Surg Oncol 43 : 1581-1588, 2017

21） Bekelman JE, et al : Effectiveness of Androgen-Deprivation Therapy and Radiotherapy for Older Men with Locally Advanced Prostate Cancer. J Clin Oncol 33 : 716-722, 2015

22） Aizawa R, et al : Increased Risk of Disease Progression in Younger Men : Analysis of Factors Predicting Biochemical Failure and Castration-Resistant Prostate Cancer After High-Dose Intensity-Modulated Radiation Therapy for Nonmetastatic Prostate Cancer. Urol Oncol 39 : 131.e9-131.e15, 2021

23） Wu YH, et al : Definitive Radiotherapy for Older Patients with Prostate Cancer : Experience of a Medical Center in Taiwan. Sci Rep 7 : 13880, 2017

24） Yamazaki H, et al : Radiothrerapy for Elderly Patients Aged ≥ 75 Years with Clinically Localized Prostate Cancer ― Is There a Role of Brachytherapy? J Clin Med 7 : 424, 2018

25） Narita S, et al : Management of Prostate Cancer in Older Patients. Jpn J Clin Oncol 52 : 513-525, 2022