근치적 전립선절제술을 시행 받은 전립선암 환자에서 술 전 전립선특이항원 수치 4 ng/ml 미만 환자의 임상 병리학적 특성 분석
Analysis of the Clinicopathologic Characteristics of Men with Prostate Cancer Undergoing Radical Prostatectomy in the Prostate-Specific Antigen Range of Less than 4 ng/ml
권택민, 정인갑, 홍준혁, 안한종, 김청수,
소속 상세정보
권택민 ( Kwon Taek-Min )
울산대학교 의과대학 비뇨기과학교실
정인갑 ( Jeong In-Gab )
울산대학교 의과대학 비뇨기과학교실
홍준혁 ( Hong Jun-Hyuk )
울산대학교 의과대학 비뇨기과학교실
안한종 ( Ahn Han-Jong )
울산대학교 의과대학 비뇨기과학교실
김청수 ( Kim Choung-Soo )
울산대학교 의과대학 비뇨기과학교실
KMID : 0358320090500040320
Abstract
Purpose: We analyzed the clinicopathologic characteristics of men undergoing radical prostatectomy in the prostate-specific antigen (PSA) range of less than 4 ng/ml and compared this with the results for men who had a PSA range of 4 to 9.9 ng/ml.
Materials and Methods: The study population consisted of 447 men treated for prostate cancer with radical prostatectomy between 1990 and 2006 at our institute who had a prebiopsy PSA of less than 10 ng/ml. The average follow-up period was 37 months. Clinicopathologic characteristics were compared between men with a PSA value of less than 4 ng/ml (low-PSA group) and men with a value in the range of 4 to 9.9 ng/ml (intermediate- PSA group). Survival analysis was performed by the Kaplan-Meier method and Cox proportional hazard regression analysis.
Results: Of these 447 patients, 60 (13.4%) and 387 (86.6%) had a low or an intermediate prebiopsy PSA level, respectively. The pathologic findings of the prostatectomy specimens showed no significant differences between the 2 groups, including Gleason score and pathologic stage. The 5-year biochemical recurrence-free survival in the low- and intermediate-PSA groups was 82.8% and 79.3%, respectively, and there was no significant difference between the 2 groups (p=0.946). Multivariate analysis showed that, in the entire cohort, pathologic Gleason score and lymph node involvement were independent predictors of biochemical recurrence.
Conslusions: No statistically significant differences were found in clinicopathologic characteristics or clinical outcome between the low- and intermediate-PSA groups. These results suggest that a lower PSA cutoff should be considered as an indication for prostate biopsy in the Korean population.
키워드
Prostate-specific antigen;Prostatic neoplasms;Prostatectomy
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