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前列腺癌根治术后,从优势侧前列腺活检阳性核心的百分比、不良病理和生化失败之间的相关性。

The correlation among the percentage of positive biopsy cores from the dominant side of prostate, adverse pathology, and biochemical failure after radical prostatectomy.

机构信息

Department of Urology, Numune Education and Research Hospital, Ankara, Turkey.

出版信息

Kaohsiung J Med Sci. 2011 Aug;27(8):307-13. doi: 10.1016/j.kjms.2011.03.009. Epub 2011 May 8.

DOI:10.1016/j.kjms.2011.03.009
PMID:21802641
Abstract

The aim of this study was to evaluate the correlation among various preoperative clinical variables, including certain prostate needle biopsy parameters, biochemical failure, and adverse pathology, after radical retropubic prostatectomy (RRP). We retrospectively evaluated the records of our 156 patients who underwent RRP because of localized prostate cancer. Serum prostate-specific antigen level, clinical stage, and the information obtained from biopsy [Gleason score, number of positive cores, percentage of positive cores (PPCs) from the dominant side of prostate, and overall PPC] were evaluated as predictors of adverse pathology and biochemical failure. Of the patients, 30.2% (n=38) had nonorgan-confined disease, 19.1% (n=24) had positive surgical margins, 11.9% (n=15) had positive seminal vesicle invasion, and 16.7% (n=21) had biochemical failure after RRP. Multivariate analysis demonstrated that a PPC value of 55% or more from the dominant side of prostate is the only independent predictor of nonorgan-confined disease and seminal vesicle invasion. Clinical stage (T2b), biopsy Gleason score, and PPC values of 55% or more from the dominant side of prostate were found to be statistically significant predictors of positive surgical margin and biochemical failure. Our results support that PPC from the dominant side of prostate is a useful parameter for the prediction of adverse pathology and biochemical failure after RRP.

摘要

本研究旨在评估根治性前列腺切除术(RRP)前后各种术前临床变量与生化失败和不良病理之间的相关性。我们回顾性评估了 156 例因局限性前列腺癌接受 RRP 的患者的记录。将血清前列腺特异性抗原水平、临床分期以及活检中获得的信息(Gleason 评分、阳性核心数、前列腺优势侧的阳性核心百分比(PPC)和总 PPC)作为不良病理和生化失败的预测因素进行评估。在这些患者中,30.2%(n=38)患有非器官受限疾病,19.1%(n=24)有阳性手术切缘,11.9%(n=15)有阳性精囊侵犯,16.7%(n=21)在 RRP 后发生生化失败。多变量分析表明,前列腺优势侧的 PPC 值为 55%或更高是发生非器官受限疾病和精囊侵犯的唯一独立预测因素。临床分期(T2b)、活检 Gleason 评分和前列腺优势侧的 PPC 值为 55%或更高是阳性手术切缘和生化失败的统计学显著预测因素。我们的研究结果表明,前列腺优势侧的 PPC 是预测 RRP 后不良病理和生化失败的有用参数。

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本文引用的文献

1
Radical prostatectomy in the 21st century - the gold standard for localized and locally advanced prostate cancer.21世纪的根治性前列腺切除术——局限性和局部进展性前列腺癌的金标准。
Front Radiat Ther Oncol. 2008;41:7-14. doi: 10.1159/000139873.
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Oncological and functional results of antegrade radical retropubic prostatectomy for the treatment of clinically localised prostate cancer.顺行性耻骨后根治性前列腺切除术治疗临床局限性前列腺癌的肿瘤学和功能结果。
Eur Urol. 2008 Mar;53(3):554-61. doi: 10.1016/j.eururo.2007.07.004. Epub 2007 Jul 16.
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Percentages of positive cores, cancer length and Gleason grade 4/5 cancer in systematic sextant biopsy are all predictive of adverse pathology and biochemical failure after radical prostatectomy.
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Int J Urol. 2007 Aug;14(8):713-8. doi: 10.1111/j.1442-2042.2007.01809.x.
4
Percentage of cancer in prostate biopsies as prognostic factor for staging and postoperative biochemical failure after radical prostatectomy.前列腺活检中癌症的百分比作为前列腺癌根治术后分期及术后生化复发的预后因素
Urol Int. 2007;78(4):328-33. doi: 10.1159/000100837.
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Percentage of positive biopsy cores, preoperative prostate-specific antigen (PSA) level, pT and Gleason score as predictors of PSA recurrence after radical prostatectomy: a multi-institutional outcome study in Japan.阳性活检核心的百分比、术前前列腺特异性抗原(PSA)水平、pT和Gleason评分作为根治性前列腺切除术后PSA复发的预测指标:日本一项多机构结局研究
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