Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
BJU Int. 2011 Jul;108(2):217-22. doi: 10.1111/j.1464-410X.2010.09814.x. Epub 2010 Nov 17.
• To investigate the outcome of patients who underwent radical prostatectomy (RP) for prostate cancer of biopsy Gleason score ≥ 8 diagnosed via contemporary prostate biopsy.
• We reviewed records of 151 patients who underwent RP for prostate cancer of biopsy Gleason score ≥ 8 detected via multi (≥ 12)-core prostate biopsy without any neoadjuvant or adjuvant treatment. • Preoperative predictors of pathologically organ-confined disease along with biochemical recurrence-free survival were analyzed via multivariate logistic regression and Cox proportional hazards model.
• For 151 total subjects, 5-year estimated biochemical recurrence-free survival rate was 41.0%. Patients with pathologically organ-confined disease were observed to have much higher 5-year biochemical recurrence-free survival rate than those otherwise (72.1 vs 31.5%, P < 0.001). • Serum PSA level (P= 0.031) and maximum tumour length in a biopsy core (P= 0.005) were observed to be significant preoperative predictors of having pathologically organ-confined disease. • As for biochemical recurrence-free survival following RP, serum PSA (P= 0.023), biopsy Gleason score (P= 0.032), and percent of total tumour length in biopsy cores (P < 0.001) were observed be significant preoperative predictors on multivariate analysis.
• Among contemporary patients with biopsy Gleason score ≥ 8 who underwent RP alone, patients with pathologically organ-confined disease demonstrated significantly better biochemical outcome than others. Serum PSA level and maximum tumour length in a biopsy core, independent predictors of organ-confined disease, would be useful in the selection of candidates for RP among patients presenting with biopsy Gleason score ≥ 8.
研究通过多核心（≥ 12 核心）前列腺活检检测到的活检 Gleason 评分≥8 的前列腺癌患者接受根治性前列腺切除术（RP）的治疗结果。
我们回顾了 151 例通过多核心前列腺活检检测到的活检 Gleason 评分≥8 的前列腺癌患者接受 RP 的记录，这些患者在接受手术前未接受任何新辅助或辅助治疗。通过多变量逻辑回归和 Cox 比例风险模型分析了术前预测病理器官局限性疾病和生化无复发生存率的因素。
在 151 例患者中，5 年估计生化无复发生存率为 41.0%。患有病理器官局限性疾病的患者的 5 年生化无复发生存率明显高于其他患者（72.1% vs 31.5%，P<0.001）。血清 PSA 水平（P=0.031）和活检核心中最大肿瘤长度（P=0.005）被观察到是具有病理器官局限性疾病的显著术前预测因素。对于 RP 后的生化无复发生存率，血清 PSA（P=0.023）、活检 Gleason 评分（P=0.032）和活检核心中肿瘤总长度的百分比（P<0.001）在多变量分析中被观察到是显著的术前预测因素。
在单独接受 RP 的当代活检 Gleason 评分≥8 的患者中，患有病理器官局限性疾病的患者的生化结果明显优于其他患者。血清 PSA 水平和活检核心中最大肿瘤长度是器官局限性疾病的独立预测因素，对于在活检 Gleason 评分≥8 的患者中选择接受 RP 的患者具有一定的指导意义。
