근치적 전립선적출술 후 발견된 다발성 전립선암의 예후적 가치
Prognostic Significance of Multifocal Tumor in Radical Prostatectomy
정재승, 한병규, 정성진, 문기혁, 최기영, 박동수, 홍성규, 변석수, 이상은,
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정재승 ( Chung Jae-Seung )
포천중문의과대학교 비뇨기과학교실
한병규 ( Han Byoung-Kyu )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
정성진 ( Jeong Seong-Jin )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
문기혁 ( Moon Ki-Hyuck )
서울대학교 의과대학 비뇨기과학교실
최기영 ( Choe Ghee-young )
분당서울대학교병원 병리학과
박동수 ( Park Dong-Soo )
서울대학교 의과대학 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 : 0358320080490060510
Abstract
Purpose: We investigate the impact of tumor multifocality on the biochemical recurrence rate after radical prostatectomy.
Material and Methods : Data was collected from 525 patients who underwent radical prostatectomy for clinically localized prostate cancer from 2003 to 2007. We evaluated the potential associations of multifocality with various clinical and pathologic factors. The ability to predict extra-capsular extension(ECE) was tested by logistic regression models, whereas biochemical recurrence(BCR) was assessed via Kaplan-Meier analyses and Cox-hazard regression models. The BCR was defined as a level of serum prostate-specific antigen(PSA) of 0.2ng/ml or greater on consecutive evaluations.
Results:Multifocality was observed to be significantly associated with the presence of a high grade Gleason pattern(p=0.014), the pT stage(p＜ 0.001), ECE(p=0.005) and a positive surgical margin(PSM)(p=0.019). Moreover, it was the independent predictor of ECE on multivariate logistic regression analyses(p=0.039). However, although multifocality had a significant influence on biochemical recurrence on the Kaplan-Meier analyses (log rank test, p=0.019), only the PSA level and the Gleason score were significant predictors of BCR on the multivariated Cox-hazard analyses.
Conclusion:Although multifocality was associated with adverse pathologic features, it had no significant effect on biochemical recurrence on the multivariated cox-hazard analyses.
키워드
Prostate cancer; Multifocality;Recurrence
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