Choi Young Hyo, Yu Ji Woong, Jeong Byong Chang, Seo Seong Il, Jeon Seong Soo, Lee Hyun Moo, Jeon Hwang Gyun
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
Diagn Pathol. 2019 Jan 12;14(1):2. doi: 10.1186/s13000-019-0782-8.
Pathological features of prostate cancer in Korean men were analyzed to determine whether identification of tumor volume, Gleason score (GS), focality, and location using radical prostatectomy (RP) specimens can provide useful information for the application of focal therapy (hemiablation).
From January 2016 to December 2017, 913 patients who underwent RP at a single center were selected for analysis. Patients with prostate-specific antigen levels > 15 ng/mL or those who had received hormone therapy prior to surgery were excluded. Preoperative data and the number, volume, location, and GS of each tumor were recorded.
Overall, 762 RP specimens were examined, and 1448 tumors were identified. The majority of the cases were multifocal (60.5%) and bilateral (82%) in nature. Among the 686 secondary tumors, 250 (36.4%) had a GS ≥7 and 122 (17.8%) had a tumor volume ≥ 0.5 mL. Among the 435 bilateral multifocal cases, secondary tumors on the lobes contralateral to the largest tumor were significant by volume (≥0.5 mL) in 91 (20.9%) cases and by grade (GS ≥7) in 179 (41.1%) cases. There were 102 (23.4%) tumors with a small tumor volume (< 0.5 mL) and Gleason pattern 4 on the lobe contralateral to the largest tumor.
Bilateral and multifocal tumors are a common feature and secondary tumors frequently exhibit clinically significant prostate cancer on RP specimens in Korea. In many cases, secondary tumors on the lobe contralateral to the largest tumor had a high GS and small tumor volume.
分析韩国男性前列腺癌的病理特征，以确定使用根治性前列腺切除术（RP）标本鉴定肿瘤体积、Gleason评分（GS）、局灶性和位置是否可为聚焦治疗（半消融）的应用提供有用信息。
选取2016年1月至2017年12月在单一中心接受RP的913例患者进行分析。排除前列腺特异性抗原水平>15 ng/mL的患者或术前接受过激素治疗的患者。记录术前数据以及每个肿瘤的数量、体积、位置和GS。
总体上，检查了762份RP标本，共识别出1448个肿瘤。大多数病例为多灶性（60.5%）和双侧性（82%）。在686个继发性肿瘤中，250个（36.4%）的GS≥7，122个（17.8%）的肿瘤体积≥0.5 mL。在435例双侧多灶性病例中，最大肿瘤对侧叶上的继发性肿瘤，按体积（≥0.5 mL）计有91例（20.9%）显著，按分级（GS≥7）计有179例（41.1%）显著。最大肿瘤对侧叶上有102个（23.4%）肿瘤体积小（<0.5 mL）且Gleason分级为4级。
双侧和多灶性肿瘤是常见特征，在韩国，RP标本上的继发性肿瘤常表现为具有临床意义的前列腺癌。在许多病例中，最大肿瘤对侧叶上的继发性肿瘤GS高且肿瘤体积小。
