근치적 전립선적출술 전 호르몬 치료가 생화학적 재발에 미치는 영향
The Effect of Neoadjuvant Hormonal Treatment in Prostate Cancer on Biochemical Recurrence
송강현, 박홍주, 한지연, 유창희, 안한종, 김청수,
소속 상세정보
송강현 ( Song Kang-hyon )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
박홍주 ( Park Hong-Zoo )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
한지연 ( Han Ji-Yeon )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
유창희 ( Yoo Chang-Hee )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
안한종 ( Ahn Han-Jong )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
김청수 ( Kim Choung-Soo )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
KMID : 0358320070480111125
Abstract
Purpose: When combined with surgery, neoadjuvant hormonal therapy (NHT) has not demonstrated a significant benefit for meaningful clinical endpoints such as progression-free survival or overall survival. We evaluated the effect of NHT on prostate cancer.
Materials and Methods: From 1995 to 2004, 519 patients underwent radical retropubic prostatectomy(RRP). One-hundred thirty of them were included in this retrospective case-control study and they were assessed for age, the preoperative prostate-specific antigen(PSA) level, the clinical stage and the biopsy Gleason score(GS). The subjects were divided into two groups: the RRP only group(n=65) and the NHT group(n=65), and these were matched for the 3 above mentioned parameters. The protocols for NHT were maximal androgen blockade(n=40), antiandrogen only(n=8), and LHRH analogue only(n=17). Biochemical recurrence was defined as a level of serum PSA of 0.2ng/ml or greater on 2 consecutive evaluations.
Results: The mean age of the RRP only group and the NHT group was 64.2 and 63.5, respectively(p＞0.05). The rates of a positive surgical margin and biochemical recurrence in the NHT group were 49.2% and 42.5%, respectively, and they were 46.2% and 46.2%, respectively, in RRP only group, and there was no statistical difference between the two groups. In high risk patients(clinical stage≥T3, biopsy GS≥8, serum PSA＞20ng/ml), NHT group was not differences compared with the RRP group. Neither the duration (3 months vs. 6 months) of NHT nor the regimens of NHT improved the clinical and surgical outcome.
Conclusions: NHT did not improve biochemical recurrence and the positive surgical margin
키워드
Prostate cancer;Neoadjuvant therapy;Recurrence
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