Tanaka Nobumichi, Fujimoto Kiyohide, Hirayama Akihide, Nakai Yasushi, Chihara Yoshitomo, Anai Satoshi, Tomioka Atsushi, Shimada Keiji, Konishi Noboru, Hirao Yoshihiko
Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
Adv Urol. 2012;2012:204215. doi: 10.1155/2012/204215. Epub 2012 May 13.
Purpose. The purpose of this study is to investigate whether the clinicopathological biopsy findings can predict the oncological outcome in patients who undergo radical prostatectomy. Materials and Methods. Between January 1997 and March 2006, 255 patients with clinically localized adenocarcinoma of the prostate (clinical T1-3N0M0) who had undergone retropubic radical prostatectomy were enrolled in this study. None of the patients received neoadjuvant or adjuvant therapy. Clinicopathological parameters were assessed to determine a predictive parameter of biochemical recurrence. Results. Of the total 255 patients, 77 showed biochemical recurrence during the follow-up period. The estimated 5-year overall survival, 5-year cause-specific survival, and 5-year biochemical recurrence-free survival rates were 97.7%, 99.5%, and 67.3%, respectively. Multivariate analysis using the Cox proportional hazards model showed that calculated cancer volume was an independent predictor among the preoperative clinicopathological parameters (P < 0.05). SVI and PSM were independent predictors among the postoperative parameters (SVI; P < 0.001, PSM; P = 0.049). Among the significant preoperative and postoperative parameters, calculated cancer volume remained an independent predictive parameter in multivariate analysis (P < 0.01). Conclusions. Tumor volume, as calculated by preoperative parameters, is an independent predictor of biochemical recurrence in patients who had undergone radical prostatectomy.
目的。本研究的目的是调查临床病理活检结果能否预测接受根治性前列腺切除术患者的肿瘤学结局。材料与方法。1997年1月至2006年3月期间,255例临床局限性前列腺腺癌(临床T1 - 3N0M0)患者接受了耻骨后根治性前列腺切除术并纳入本研究。所有患者均未接受新辅助或辅助治疗。评估临床病理参数以确定生化复发的预测参数。结果。在总共255例患者中,77例在随访期间出现生化复发。估计的5年总生存率、5年病因特异性生存率和5年无生化复发生存率分别为97.7%、99.5%和67.3%。使用Cox比例风险模型进行的多变量分析显示,在术前临床病理参数中,计算得出的癌体积是一个独立的预测因素(P < 0.05)。在术后参数中,包膜外侵犯(SVI)和切缘阳性(PSM)是独立的预测因素(SVI;P < 0.001,PSM;P = 0.049)。在术前和术后的显著参数中,计算得出的癌体积在多变量分析中仍然是一个独立的预测参数(P < 0.01)。结论。通过术前参数计算得出的肿瘤体积是接受根治性前列腺切除术患者生化复发的独立预测因素。