저위험군 전립선암에서 근치적 전립선절제술 후 Gleason 점수의 상승의 예측 인자
Predictors of Gleason Score Upgrading after Radical Prostatectomy in Low-Risk Prostate Cancer
임택, 임정식, 정영범, 박승철, 김형진,
소속 상세정보
임택 ( Lim Taek )
원광대학교 의과대학 비뇨기과학교실
임정식 ( Rim Joung-Sik )
원광대학교 의과대학 비뇨기과학교실
정영범 ( Jeong Young-Beom )
전북대학교 의학전문대학원 비뇨기과학교실
박승철 ( Park Seung-Chol )
원광대학교 의과대학 비뇨기과학교실
김형진 ( Kim Hyung-Jin )
전북대학교 의학전문대학원 비뇨기과학교실
KMID : 0358320090500121182
Abstract
Purpose: The Gleason score is an important predictor of outcome that is used in conjunction with clinical stage and prostate-specific antigen to guide clinical decision making. The prostate biopsy Gleason grade frequently differs from the radical prostatectomy grade. The aim of this study was to determine the risk factors of Gleason upgrading in patients with low-risk prostate cancer after radical prostatectomy.
Materials and Methods: We retrospectively analyzed the medical records of 146 patients who underwent radical prostatectomy between 1998 and 2008 in two hospitals of Jeonbuk province in Korea. Pathological Gleason score upgrading was defined as an increase in the Gleason score from ≤6 to ≥7 between the biopsy and radical prostatectomy specimen. Pretreatment clinical and pathological parameters were used to identify predictors of pathological upgrading.
Results: Of the total 146 patients, 51 (34.9%) were upgraded postoperatively. Small prostate volume (p=0.008), abnormality on the digital rectal examination, and positive surgical margin (p=0.001) were significantly and positively associated with upgrading after radical prostatectomy. A total of 17 of 65 patients with low-risk prostate cancer (26.2%) were upgraded postoperatively. Small prostate volume (＜30 ml) was significantly (p= 0.026) and positively associated with upgrading after radical prostatectomy in patients with low-risk prostate cancer.
Conclusions: Overall, 26% of patients with low-risk disease were upgraded postoperatively. Small prostate volume was associated with an increased risk for pathological upgrading after radical prostatectomy. These conclusions should be kept in mind when making treatment decisions for men with low-risk prostate cancer.
키워드
Prostatic neoplasms;Prostatectomy;Risk factors
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