한국인 전립선암의 임상 병리학적 특징 및 임상적 국소 전립선암에 대한 병리학적 병기의 예측 노모그램: 다기관 연구
Clinico-pathological Characteristics of Prostate Cancer in Korean Men and Nomograms for the Prediction of the Pathological Stage of the Clinically Localized Prostate Cancer: A Multi-institutional Update
송채린, 강태진, 이무성, 노재윤, 이상은, 이은식, 최한용, 한덕현, 홍성준, 정병하, 김청수, 안한종,
소속 상세정보
송채린 ( Song Cheryn )
울산대학교 의과대학 비뇨기과학교실
강태진 ( Kang Tae-jin )
울산대학교 의과대학 비뇨기과학교실
이무성 ( Lee Moo-Song )
울산대학교 의과대학 예방의학교실
노재윤 ( Ro Jae Y. )
울산대학교 의과대학 병리학교실
이상은 ( Lee Sang-Eun )
서울대학교 의과대학 비뇨기과학교실
이은식 ( Lee Eun-Sik )
서울대학교 의과대학 비뇨기과학교실
최한용 ( Choi Han-Yong )
성균관대학교 의과대학 비뇨기과학교실
한덕현 ( Han Deok-Hyun )
성균관대학교 의과대학 비뇨기과학교실
홍성준 ( Hong Sung-Joon )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
정병하 ( Chung Byung-Ha )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
김청수 ( Kim Choung-Soo )
울산대학교 의과대학 비뇨기과학교실
안한종 ( Ahn Han-Jong )
울산대학교 의과대학 비뇨기과학교실
KMID : 0358320070480020125
Abstract
Purpose: In this multi institutional study, the data of 604 men with clinically localized prostate cancer, who underwent radical prostatectomy, with updated nomograms predicting the pathological stage, were analyzed.
Materials & Methods: Prostate biopsies and prostatectomy specimens from men treated with radical prostatectomy, obtained between 1990 and 2003, were included. The patient distribution with respect to clinical stage, serum prostate-specific antigen(PSA) and biopsy Gleason score, as well as final pathological findings, including organ-confined disease(OCD), extracapsular extension(ECE), seminal vesicle invasion(SVI), and lymph node metastasis(LNM), were analyzed for the construction of nomograms representing the percent probabilities of each respective pathological outcome.
Results: The median serum PSA at the time of surgery and biopsy Gleason score were 9.9ng/ml and 7, respectively. The preoperative serum PSA was 4ng/ml or less in 38(6.3%) patients and the tumor was impalpable in 292 (48.2%) of patients. The biopsy Gleason scores were 7 and 8 or higher in 186(30.7%) and 169(27.9%), respectively. Throughout the clinical stages and PSA ranges, the Gleason score was 7 or higher in more than 50% of patients, but 8-10 in 20-30%. The overall OCD, ECE, SVI and LNM rates were 57.1, 27.8, 10.9 and 4.2%, respectively.
Conclusion: A significantly high proportion of prostate cancers arising in Korean men exhibited poor differentiation, with Gleason scores of 7 or higher, regardless of the clinical stage or initial serum PSA. Updated nomograms acknowledging such characteristics have been developed, which may aid in the treatment planning of these individuals. (Korean J Urol 2007;48:125-130)
키워드
Prostate neoplasm;Prostatectomy;Nomograms
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