병리학적 T0 병기 전립선암의 병리학적 특성과 예후
Pathologic Characteristics and Prognosis of Pathologic T0 Prostate Cancer
이승렬, 함원식, 김원태, 주희정, 이진선, 최영득,
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이승렬 ( Lee Seung-Ryeol )
연세대학교 의과대학 비뇨기과학교실
함원식 ( Ham Won-Sik )
연세대학교 의과대학 비뇨기과학교실
김원태 ( Kim Won-Tae )
연세대학교 의과대학 비뇨기과학교실
주희정 ( Ju Hee-Jeong )
연세대학교 의과대학 비뇨기과학교실
이진선 ( Lee Jin-Sun )
연세대학교 의과대학 비뇨기과학교실
최영득 ( Choi Young-Deuk )
연세대학교 의과대학 비뇨기과학교실
KMID : 0358320090500030229
Abstract
Purpose: We evaluated the pathologic characteristics and prognosis of pathologic T0 (pT0) prostate cancer (PC).
Materials and Methods: Of 1,196 consecutive men who underwent radical prostatectomy (RP) between January 1992 and November 2008, 34 patients (mean age, 68.8±7.9 years; range, 48-85) had pT0 PC. They were categorized into 4 groups according to neoadjuvant hormone therapy (NHT) and diagnostic methods. The initial PSA, 5 alpha-reductase inhibitor (5αRI), Gleason score of prostatic needle biopsy (PNB) or transurethral resection of the prostate (TURP), clinical stage, and presence of high-grade prostatic intraepithelial neoplasia were evaluated. Clinical and biochemical progression were also evaluated.
Results: 34 patients were categorized into 4 groups (Group I: 9 without NHT, diagnosed by PNB [1.1%]; Group II: 8 without NHT, diagnosed by TURP [11.3%]; Group III: 16 with NHT, diagnosed by PNB [5.5%]; Group IV: 1 with NHT, diagnosed by TURP [3.8%]). Group I had serum prostate-specific antigen (PSA)＜15.0 ng/ml, one positive biopsy core, and a Gleason score≤7. Group II had serum PSA＜10.1 ng/ml, chips involved with cancer＜10.0%, and a Gleason score≤6. There were more patients taking 5αRI and high-grade PIN among patients without NHT. None of patients with pathologic pT0 PC had clinical or biochemical progression during follow-up, except 3 patients with NHT (mean, 22 months; range,
2-105 months).
Conclusions: Patients without NHT had more favorable clinical and pathologic results. In our study, except for 3 patients with NHT, all patients had undetectable PSA levels after RP. We need more time for follow-up to conclude whether the prognosis of pT0 PC is favorable.
키워드
Prostatic neoplasms;Prostatectomy
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