Clinical Observations on Prostatic Carcinoma(1966-1975)

Chung, Chung Man; Wang, Chong Soon

Abstract

One of the most important diseases in urological practice is prostatic carcinoma. It is a common cause of death in aging white males over 50 years old. It is well known that its incidence has a significant differences according to race and geographic area (Whites have a higher incidence than Orientals). Recently prostatic carcinoma has been considered as a important disease, because its occurrence rate has been increasing year by year in Korea. Thirty cases of prostatic carcinoma (It biopsy proven and 16 clinically manifested cases) which were admitted during a 10 year period, from Jan. 1966 to Dec. 1975 were studied from a clinical view point retrospectively in the Department of Urology, Yonsei University, College of Medicine. The results were as follows; 1. During this period, the total number of inpatients were 2,814(2,006 male and 808 female) among which 30 cases had prostatic carcinoma, giving a rate of 1.1% and the percentages of prostatic carcinoma to total male inpatients, total male genitourinary tract tumor patients and total male inpatients over 50 years old were 1.5%, 11.3% and 2.7% respectively. The incidence of prostatic carcinoma as shown above indicates an increased trend year by year. 2. The age distributions ranged from 30 years to 82 years with the most common age groups in the 7th and 8th decades. 3. The duration of symptoms ranged from 28 days to 4 years (mean: 13.2 months) and the presenting symptoms were bladder neck obstruction symptoms in 11 patients (80. 0%), bone pain in 9 patients (30.0%), gross hematuria in 9 patients (30%) and constipation in 11 patients (36.7%). 4. Fourteen cases showed adenocarcinoma among 16 prostatic biopsies and the perineal aspiration biopsy yielded the lowest rate of diagnosis. 5. Among 18 cases which metastasis were confirmed radiologically, bone (9 cases) was the most frequent site of metastasis and the next were bladder neck (4cases). Lymph nodes, lung and liver were also involved. 6. Serun acid and alkaline phosphatase determinations were done in 27 cases. Eighteen patients had elevated serum acid phosphatase, 14 with metastasis and 4 without metastasis. Twelve patients had elevated serum alkaline phosphatase, 8 with bony metastasis and 4 without bony metastasis. 7. The coexisting sisease with prostatic carcinoma were cardiovascular diseases (12 cases), pulmonary disease (10 cases), urinary tract infections (7 cases), hydronephrosis (6 cases), B.P.H. (4 cases), bladder tumor (2 cases) and vesical diverticulum (2 cases). 8. All patients were suggested as stage D and treated palliatively such as endocrine therapy, radiation therapy and conservative surgery. Most of the patients were lost to follow up and 4 patients had been observed for 2,3,9 and 14 months period.