혈청 PSA가 20ng/ml 이상인 임상적 국소 전립선암에서 1차적 치료로서 근치적 전립선적출술의 유용성
Efficacy of Radical Retropubic Prostatectomy as the Primary Treatment for Patients with Clinically Localized Prostate Cancer and a Serum PSA Level ≥20ng/ml
한준현, 장인호, 유지형, 한병규, 정성진, 홍성규, 변석수, 이상은,
소속 상세정보
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 )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
정성진 ( Jeong Seong-Jin )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
홍성규 ( Hong Sung-Kyu )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
변석수 ( Byun Seok-Soo )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
이상은 ( Lee Sang-Eun )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
KMID : 0358320070480090945
Abstract
Purpose:We retrospectively reviewed the clinicopathological characteristics ofpatients who underwent radical retropubic prostatectomy(RRP), and these patients had clinically localized prostate cancer and a preoperative serum prostate-specific antigen(PSA) level ≥20ng/ml.
Materials and Methods:Among the 266 patients who underwent RRP without any prior neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a preoperative serum PSA level ≥20ng/ml. We analyzed several clinicopathologic factors that might predict organ-confined disease.
Results:Of the 29 patients, 11(37.9%) had organ-confined cancer. The level of serum PSA, the PSA density(PSAD), the Gleason score(3+4 or less), the prostate volume, tumor volume and the tumor percentage were significant factors for predicting organ-confined cancer(p＜0.05). The number of the positive cores, the percentage of the core material that was positive, the sum of the tumor length of the positive core, tumor percent of the total core length and tumor percent of the positive core length were also significantly higher in the group with an extraprostatic extension of disease compared tothe organ-confined cancer group(p＜0.05).
Conclusions:For the patients with clinically localized prostate cancer and a serum PSA level ≥20ng/ml, radical prostatectomy can be considered as the primary treatment for some cases that have a relatively lower PSA and PSAD, a biopsy Gleason score of 3+4 or less and low predictive volume of the tumor from the biopsy results. (Korean J Urol 2007;48:945-950)
키워드
Prostatectomy;Prostate-specific antigen;Biopsy
원문 및 링크아웃 정보
등재저널 정보