Carcinoma of the prostate - A study of the percentage or cases suitable for the radical operation J. A. C. Colston Journal of the American Medical Association 1943 122: 781-784
Colston commented on these statistics:
"I realize that this percentage of cases suitable for the radical operation is probably higher than would be seen in other clinics, but it can be explained by the fact that many patients are referred to this clinic with a diagnosis of early carcinoma for the express purpose of undergoing the radical operation."Colston was also adamant that the operation was performed in patients "considered suitable for the radical operation with a good prognosis for complete cure." He laid out the following selection criteria for curative radical prostatectomy:
- organ-confined disease (no locally advanced disease) on clinical examination
- no evidence of metastases on radiography
- serum acid and basic phosphatase are within normal limits
- satisfactory general health ("a fair span of life expectancy")
He also described the palliative operation in cases where cancer extended beyond the tips of the seminal vesicles or invaded the bladder neck. In both cases, "the patient's subsequent course was much more satisfactory than with any other method of treatment."
Colston also reported the oncologic outcomes:
Interestingly, the only pre-operative prognostic factor was digital rectal examination (DRE). HH Young was able to dichotomize patients into "good-" or "poor-risk" based on their DRE and this correlated very well with outcome: 41 of 43 patients with a good-risk DRE were alive at last follow-up, while 18 of 26 patients with poor-risk DRE had a cancer recurrence or were dead.
Finally, Colston was also able to report functional outcomes, with good control in most patients. In addition, a modified suture technique, employed in 1940, resulted in a greater proportion of patients with "good urinary control."
To read the entire manuscript: follow the link above, visit the Centennial Website or click here.
HISTORICAL CONTRIBUTIONS highlight the greatest academic manuscripts from the Brady Urological Institute over the past 100 years. As the Brady Urological Institute approaches its centennial, we will present a HISTORICAL CONTRIBUTION from each of the past 100 years. In the most recent experience, the most highly cited article from each year is selected; older manuscripts were selected based on their perceived impact on the field. We hope you enjoy!
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of theReplyDelete
liver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.