Department of Urology, Numune Education and Research Hospital, Ankara, Turkey.
Kaohsiung J Med Sci. 2011 Aug;27(8):307-13. doi: 10.1016/j.kjms.2011.03.009. Epub 2011 May 8.
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.
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。