전립선 생검상 Gleason 점수 8 이상이고 임상적 국소 전립선암에서 근치적 전립선적출술의 유용성
Efficacy of Radical Retropubic Prostatectomy in Patients with Clinically Localized Prostate Cancer and a Biopsy Gleason Score of 8 or Higher
한준현, 장인호, 유지형, 한병규, 정성진, 홍성규, 변석수, 이상은,
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한준현 ( Han Jun-Hyun )
한전의료재단 한일병원 비뇨기과학교실
장인호 ( Chang In-Ho )
한전의료재단 한일병원 비뇨기과학교실
유지형 ( Yu Ji-Hyeong )
인제대학교 의과대학 상계백병원 비뇨기과학교실
한병규 ( Han Byoung-Kyu )
분당서울대학교병원 비뇨기과
정성진 ( Jeong Seong-Jin )
분당서울대학교병원 비뇨기과
홍성규 ( Hong Sung-Kyu )
분당서울대학교병원 비뇨기과
변석수 ( Byun Seok-Soo )
분당서울대학교병원 비뇨기과
이상은 ( Lee Sang-Eun )
분당서울대학교병원 비뇨기과
KMID : 0358320070480060592
Abstract
Purpose: We retrospectively reviewed clinicopathological characteristics in patients who underwent radical retropubic prostatectomy(RRP) with clinically localized prostate cancer and a biopsy Gleason score of 8 or higher.
Materials and Methods: Among 266 patients who underwent RRP without prior any neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a biopsy Gleason score of 8 or higher. We analyzed several clinicopathologic factors that predict organ-confined disease, and also investigated the impact on postoperative changes of the biopsy Gleason score.
Results: Of 29 patients, 12(41.4%) had organ-confined cancer. Serum prostate-specific antigen(PSA), prostate-specific antigen density(PSAD), tumor volume, and tumor percentage were significant factors for predicting organ-confined cancer(p＜0.05). The number of the positive core, percentage of the positive core, sum of the tumor length of the positive core, tumor percentage of total core length, and tumor percentage of the positive core length were also significantly higher in the group with an extraprostatic extension compared to the organ-confined cancer group (p＜0.05). Of 29 patients, 14(48.3%) were downgraded to a Gleason score of 7 or less and had a higher chance(64.3%; p=0.016) of experiencing organ- confined disease than those that remained at Gleason scores of 8-10.
Conclusions: Among patients with clinical localized prostate cancer and a biopsy Gleason score of 8 or higher, radical prostatectomy can be considered for primary treatment in some cases with low PSA and PSAD and low predictive volume of the tumor from biopsy results. (Korean J Urol 2007;48:592-597)
키워드
Prostatectomy;Biopsy;Prostatic neoplasms
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