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概要：
Vinciがよいと考えられる．Ⅷおわりに限局性早期前立腺癌は増加傾向にあり，リスク分類を加味した個別化治療戦略が求められている．本稿では，D’Amicoのリスク分類を用いて根治性の面から治療戦略を解説した．一方....

Vinciがよいと考えられる．Ⅷおわりに限局性早期前立腺癌は増加傾向にあり，リスク分類を加味した個別化治療戦略が求められている．本稿では，D’Amicoのリスク分類を用いて根治性の面から治療戦略を解説した．一方で，根治性をエンドポイントとした各種治療にはさほど優劣がなく，QOLをエンドポイントとする新たな時代に突入した．PSA監視療法や高リスク群へのBTなど，現在進行中の新たな研究が多くあり，今後のデータの蓄積が待たれる．参考文献1）D’Amico AV, Whittington R, Malkowicz SB, et al：Biochemicaloutcome after radical prostatectomy, external beam radiationtherapy, or interstitial radiation therapy for clinicallylocalized prostate cancer. JAMA 280：969-974, 19982）Boorjian SA, Karnes RJ, Rangel LJ, et al：Mayo Clinic validationof the D’amico risk group classification for predictingsurvival following radical prostatectomy. J Urol 179：1354 -1360, 20083）Stattin P, Holmberg E, Johansson JE, et al；National ProstateCancer Register（NPCR）of Sweden：Outcomes in localizedprostate cancer：National Prostate Cancer Register of Swedenfollow-up study. J Natl Cancer Inst 102：950-958, 20104）Albertsen PC, Hanley JA, Fine J：20 -year outcomes followingconservative management of clinically localized prostatecancer. JAMA 293：2095-2101, 20055）Kakehi Y, Kamoto T, Shiraishi T, et al：Prospective evaluationof selection criteria for active surveillance in Japanesepatients with stage T1cN0M0 prostate cancer. Jpn J ClinOncol 38：122 -128, 20086）Hernandez DJ, Nielsen ME, Han M, et al：Contemporaryevaluation of the D’amico risk classification of prostate cancer.Urology 70：931-935, 20077）Kawamorita N, Saito S, Ishidoya S, et al：Radical prostatectomyfor high-risk prostate cancer：biochemical outcome. IntJ Urol 16：733 -738, 20098）Potters L, Klein EA, Kattan MW, et al：Monotherapy forstage T1 -T2 prostate cancer：radical prostatectomy, externalbeam radiotherapy, or permanent seed implantation.Radiother Oncol 71：29-33, 20049）Grossfeld GD, Latini DM, Lubeck DP, et al：Predicting recurrenceafter radical prostatectomy for patients with high riskprostate cancer. J Urol 169：157-163, 200310）Mian BM, Troncoso P, Okihara K, et al：Outcome of patientswith Gleason score 8 or higher prostate cancer following radicalprostatectomy alone. J Urol 167：1675-1680, 200211）Potosky AL, Davis WW, Hoffman RM, et al：Five-year outcomesafter prostatectomy or radiotherapy for prostate cancer：theprostate cancer outcomes study. J Natl Cancer Inst96：1358-1367, 200412）Litwin MS, Hays RD, Fink A, et al：The UCLA ProstateCancer Index：development, reliability, and validity of ahealth-related quality of life measure. Med Care 36：1002 -1012, 199813）Wei JT, Dunn RL, Litwin MS, et al：Development and validationof the expanded prostate cancer index composite（EPIC）for comprehensive assessment of health -relatedquality of life in men with prostate cancer. Urology 56：899 -905, 200014）Kakehi Y, Takegami M, Suzukamo Y, et al：Health relatedquality of life in Japanese men with localized prostate cancertreated with current multiple modalities assessed by a newlydeveloped Japanese version of the Expanded Prostate CancerIndex Composite. J Urol 177：1856-1861, 200715）Namiki S, Ishidoya S, Ito A, et al：Quality of life after radicalprostatectomy in Japanese men：a 5 -Year follow up study.Int J Urol 16：75-81, 200916）Hart SL, Latini DM, Cowan JE, et al；CaPSURE Investigators：Fearof recurrence, treatment satisfaction, and qualityof life after radical prostatectomy for prostate cancer. SupportCare Cancer 16：161-169, 200817）Miller DC, Sanda MG, Dunn RL, et al：Long-term outcomesamong localized prostate cancer survivors：health -relatedquality-of-life changes after radical prostatectomy, externalradiation, and brachytherapy. J Clin Oncol 23：2772 -2780,200518）Namiki S, Tochigi T, Kuwahara M, et al：Health relatedquality of life in Japanese men after radical prostatectomy orradiation therapy for localized prostate cancer. Int J Urol11：619-627, 200419）Namiki S, Saito S, Satoh M, et al：Quality of life after radicalprostatectomy in Japanese men：2 year longitudinal study.Jpn J Clin Oncol 35：551-558, 200520）Namiki S, Ishidoya S, Tochigi T, et al：Health-related qualityof life after intensity modulated radiation therapy for localizedprostate cancer：comparison with conventional and conformalradiotherapy. Jpn J Clin Oncol 36：224-230, 200621）Namiki S, Satoh T, Baba S, et al：Quality of life after brachytherapyor radical prostatectomy for localized prostate cancer：aprospective longitudinal study. Urology 68：1230 -1236, 200622）Malcolm JB, Fabrizio MD, Barone BB, et al：Quality of lifeafter open or robotic prostatectomy, cryoablation or brachytherapyfor localized prostate cancer. J Urol 183：1822 -1828,201023）Potters L, Torre T, Fearn PA, et al：Potency after permanentprostate brachytherapy for localized prostate cancer.Int J Radiat Oncol Biol Phys 50：1235-1242, 200124）Stock RG, Kao J, Stone NN：Penile erectile function afterpermanent radioactive seed implantation for treatment ofprostate cancer. J Urol 165：436 -439, 200125）Zelefsky MJ, Wallner KE, Ling CC, et al：Comparison of the5 -year outcome and morbidity of three -dimensional conformalradiotherapy versus transperineal permanent iodine-125implantation for early -stage prostatic cancer. J Clin Oncol32Current Therapy 2012 Vol.30 No.9900