Biochemical Recurrence-Free and Cancer-Specific Survival after Radical Prostatectomy at a Single Institution
김성철, 정인갑, 송채린, 홍준혁, 김청수, 안한종,
소속 상세정보
김성철 ( Kim Seong-Cheol )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
정인갑 ( Jeong In-Gab )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
송채린 ( Song Che-Ryn )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
홍준혁 ( Hong Jun-Hyuk )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
김청수 ( Kim Choung-Soo )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
안한종 ( Ahn Han-Jong )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
KMID : 0358320100510120836
Abstract
Purpose: To analyze the biochemical recurrence-free and cancer-specific survival after radical prostatectomy in a consecutive series of patients with prostate cancer.
Materials and Methods: We retrospectively reviewed data for 1,822 patients who underwent radical prostatectomy with pelvic lymph node dissection at our institution between 1990 and 2009. After excluding 498 patients who were treated with neoadjuvant androgen deprivation therapy or who were followed up for ≤6 months, we included 1324 patients (mean age, 64.4 years; mean prostate-specific antigen [PSA] level, 12.3 ng/ml). We assessed patient age at the time of surgery, preoperative PSA concentration, biopsy and pathologic Gleason scores, pathologic stage, surgical margin status, disease progression, and survival.
Results: The mean follow-up time was 40 months (range, 6-193 months). The 5- and 10-year biochemical recurrence-free survival rates were 73.2% and 66.2%, respectively, and the 10-year cancer-specific survival rate was 92.4%. The mean time from surgery to biochemical recurrence was 18 months. In the multivariate analysis, Gleason score (4+3 vs. 2-6, p=0.004; 8-10 vs. 2-6, p<0.001), pathologic stage (pT3a vs. pT2, p=0.001; pT3b-4 vs. pT2, p<0.001; pN1 vs. pT2, p<0.001), and resection margin status (p<0.001) were statistically significant predictors of biochemical recurrence, with only pathologic stage (pT3b-4 vs. pT2, p=0.006; pN1 vs. pT2, p=0.010) being a statistically significant predictor of cancer-specific survival.
Conclusions: Radical prostatectomy resulted in favorable cancer control in more than 70% of patients after 5 years and a low (<10%) cancer-specific mortality rate after 10 years. The factors predictive of biochemical recurrence were Gleason score, pathologic stage, and resection margin status.
키워드
Prostatectomy; Prostatic neoplasms
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