Yokomizo Akira, Murai Masaru, Baba Shiro, Ogawa Osamu, Tsukamoto Taiji, Niwakawa Masashi, Tobisu Ken-Ichi, Kinukawa Naoko, Naito Seiji
Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
BJU Int. 2006 Sep;98(3):549-53. doi: 10.1111/j.1464-410X.2006.06379.x.
To evaluate the clinical outcome of radical prostatectomy (RP) in Japan, by retrospectively analysing the clinicopathological data in patients with clinical T1-T2 prostate cancer treated by RP, as there can be prostate-specific antigen (PSA) recurrence after RP in substantially many patients, and its character can differ according to ethnic group and/or country.
We reviewed 1192 patients who had a RP from 1993 to 2002 with no neoadjuvant/adjuvant therapy and whose PSA level after RP decreased at least once to undetectable levels (<0.2 ng/mL). PSA recurrence was defined as > or = 0.20 ng/mL. The patient data were collected from the Urological Oncology Study Group, a subgroup of Japan Clinical Oncology Group.
The patients' median (range) age was 67 (47-83) years and their PSA level before RP was 8.7 (1.0-153) ng/mL. During the median follow-up of 45.6 months, 302 of the 1192 patients (25.3%) developed PSA recurrence. The median time to recurrence was 369 (61-2128) days after RP. A log-rank test showed that five significant clinicopathological factors were associated with PSA recurrence after RP: the percentage of prostate needle-biopsy cores with cancer, the biopsy Gleason score, PSA level before RP, pathological stage, and the Gleason score of the RP specimen (P < 0.001 for all). In multivariate analyses, the percentage of positive biopsy cores, PSA level before RP, pT and the Gleason score of the RP specimen were all independent significant predictors of PSA recurrence after RP in Japanese men.
The frequency of PSA recurrence after RP was 25.3% in Japan and the percentage of positive biopsy cores, PSA level before RP, pT and the Gleason score of the RP specimen were independent significant factors for PSA recurrence.
通过回顾性分析接受根治性前列腺切除术（RP）治疗的临床T1 - T2期前列腺癌患者的临床病理数据，评估日本RP的临床疗效。因为相当多患者在RP后会出现前列腺特异性抗原（PSA）复发，且其特征可能因种族和/或国家而异。
我们回顾了1993年至2002年期间接受RP且未进行新辅助/辅助治疗、RP后PSA水平至少有一次降至不可检测水平（<0.2 ng/mL）的1192例患者。PSA复发定义为≥0.20 ng/mL。患者数据来自日本临床肿瘤学会下属的泌尿外科肿瘤学研究组。
患者的中位（范围）年龄为67（47 - 83）岁，RP前PSA水平为8.7（1.0 - 153）ng/mL。在中位随访45.6个月期间，1192例患者中有302例（25.3%）出现PSA复发。复发的中位时间为RP后369（61 - 2128）天。对数秩检验显示，五个显著的临床病理因素与RP后PSA复发相关：前列腺穿刺活检癌灶阳性芯的百分比、活检Gleason评分、RP前PSA水平、病理分期以及RP标本的Gleason评分（所有P < 0.001）。多因素分析中，活检阳性芯的百分比、RP前PSA水平、pT以及RP标本的Gleason评分均是日本男性RP后PSA复发的独立显著预测因素。
在日本，RP后PSA复发率为25.3%，活检阳性芯的百分比、RP前PSA水平、pT以及RP标本的Gleason评分是PSA复发的独立显著因素。
