Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Int J Clin Oncol. 2011 Oct;16(5):553-9. doi: 10.1007/s10147-011-0226-2. Epub 2011 Mar 25.
The aim of this study was to evaluate the oncological outcomes in patients who underwent radical prostatectomy in various risk groups.
The subjects were 468 patients with clinically localized or locally advanced adenocarcinoma of the prostate (T1-3N0M0) who underwent retropubic radical prostatectomy with/without neoadjuvant and/or adjuvant therapy at Nara Medical University and its affiliated hospitals between January 1997 and December 2006. All patients were stratified by D'Amico risk classification. The independent predictor of biochemical recurrence was determined in each risk group.
Of all 468 patients, 171 patients showed biochemical recurrence during a mean follow-up period of 53 months. The 5-year estimated biochemical recurrence-free survival rates in the low, intermediate, and high-risk groups were 77.3, 71.3, and 46.3%, respectively. The multivariate analysis using Cox's proportional hazard model showed that patient age in the low-risk group, seminal vesicle involvement in the intermediate-risk group, and prostate-specific antigen value at diagnosis, surgical Gleason score, percent positive core, and perineural invasion in the high-risk group were independent predictors of biochemical recurrence.
The high-risk patients showed a significant higher biochemical recurrence than the low- and intermediate-risk patients. The independent predictor of biochemical recurrence was different in each risk group.
本研究旨在评估在不同风险组接受根治性前列腺切除术的患者的肿瘤学结果。
本研究对象为 468 例经奈良医科大学及其附属医院于 1997 年 1 月至 2006 年 12 月间接受经耻骨后根治性前列腺切除术加/或新辅助和/或辅助治疗的局限性或局部进展性前列腺腺癌（T1-3N0M0）的临床患者。所有患者均按 D'Amico 风险分类分层。在每个风险组中确定生化复发的独立预测因子。
在所有 468 例患者中，有 171 例患者在平均随访 53 个月期间出现生化复发。低、中、高危组的 5 年生化无复发生存率分别为 77.3%、71.3%和 46.3%。使用 Cox 比例风险模型的多变量分析显示，低危组患者年龄、中危组精囊侵犯、高危组前列腺特异性抗原值、手术 Gleason 评分、阳性核心百分比和神经周围侵犯是生化复发的独立预测因子。
高危患者的生化复发率明显高于低危和中危患者。生化复发的独立预测因子在每个风险组中均不同。
