국소 전립선암에서 종양용적 및 종양용적 비율의 예후적 가치
Prognostic Significance of the Tumor Volume and Tumor Percentage for Localized Prostate Cancer
정재승, 정성진, 한병규, 홍성규, 변석수, 이상은, 최기영,
소속 상세정보
정재승 ( Chung Jae-Seung )
포천중문의과대학교 비뇨기과학교실
정성진 ( Jeong Seong-Jin )
분당서울대학교병원 비뇨기과
한병규 ( Han Byoung-Kyu )
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
최기영 ( Choi Ghee-Young )
서울대학교 의과대학 분당서울대학교병원 병리과학교실
KMID : 0358320080490121074
Abstract
Purpose: Tumor volume has been thought to be an important predictive factor for significant prostate cancer. We assessed the impact of the tumor volume(TV) and the tumor percentage(TP) of radical prostatectomy specimens on the pathological variables and the oncological outcome.
Materials and Methods: The tumor percentage and tumor volume were calculated for 525 cases by a single pathologist who determined the volume based on the surface area of the slides involved by tumor of the prostate. Univariate and multivariate logistic regression analyses were used to characterize the association of TP categories(＜5%, 5-10%, 11-20% and ＞20%) and TV(＜1.8cc, 1.8-3.7cc, 3.8-7.5cc, ＞7.5cc) with the clinicopathological variables. Biochemical recurrence(BCR) was estimated using Kaplan-Meier analysis and Cox’s hazard regression model.
Results: The mean prostate cancer volume was 6.5±8.5cc(median: 3.8, range: 0.04-73.8) and the mean percent tumor composition was 0.17±0.19 (median: 0.1, range: 0.01-0.95). A higher tumor volume and a higher tumor percentage were associated with extra-capsular extension(ECE), a positive surgical margin(PSM), a higher pT stage and a higher prostate-specific antigen(PSA) Gleason score(all p＜0.05). In addition, TP was the independent predictor of ECE(adjusted odds ratio(OR): 22.66, 95% confidence interval(CI): 1.801-285.079, p=0.016), but the tumor volume was not associated with ECE on the multivariate logistic analyses. On the Kaplan-Meier analysis, but not on the Cox-hazard analyses, the TP did demonstrate a significant association with biochemical recurrence(p=0.035), yet the TV did not reach statistical significance(p=0.190).
Conclusions: Our data indicates that the tumor percentage had a significant effect on the BCR on the Kaplan-Meier analysis. The tumor percentage rather than the tumor volume might be more useful to predict the prognosis of prostate cancer.
키워드
Prostatic neoplasms;Prostatectomy;Recurrence
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