Hospital Medicine Center, Division of Urology, Seoul National University Hospital, Seoul, Korea.
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Investig Clin Urol. 2020 May;61(3):269-276. doi: 10.4111/icu.2020.61.3.269. Epub 2020 Apr 21.
The clinical behavior of prostate cancer differs by race and ethnicity; however, data on the Korean population are scarce. We assessed the long-term oncologic outcomes of clinically localized prostate cancer after radical prostatectomy in Korean men.
We analyzed 786 clinically localized prostate cancer patients who underwent radical prostatectomy, from June 1993 to June 2008. Kaplan-Meier survival curve analysis and log-rank test were used to assess the oncologic outcomes.
The mean age of the patients was 64.9±6.6 years. Pelvic lymph node dissection was performed in 373 patients. Pathologic T and N stage cancer with local advancement and invasion were detected by radical prostatectomy in 307 and 22 patients, respectively. In total, 38 patients who underwent adjuvant therapy were excluded from the analysis of progression after biochemical recurrence (BCR), which occurred in 261 men. In total, 219 patients underwent salvage treatment. Local recurrence and distant metastasis occurred in 109 and 42 patients, respectively; 36 patients experienced metastasis with local recurrence. Castration-resistant prostate cancer developed in 22 patients, and overall and disease-specific mortality was noted in 148 and 23 patients, respectively. The median duration from operation to BCR, BCR to metastasis, and metastasis to disease-specific death was 25, 40, and 22 months, respectively.
We demonstrated the long-term prognosis of localized prostate cancer after radical prostatectomy among Koreans. Our results differ from those reported in the Western literature, with a lower prevalence of distant metastasis and shorter time to metastasis after BCR.
前列腺癌的临床行为因种族和民族而异；然而，有关韩国人群的数据却很少。我们评估了韩国男性根治性前列腺切除术后局限性前列腺癌的长期肿瘤学结果。
我们分析了 1993 年 6 月至 2008 年 6 月期间接受根治性前列腺切除术的 786 例局限性前列腺癌患者。使用 Kaplan-Meier 生存曲线分析和对数秩检验评估肿瘤学结果。
患者的平均年龄为 64.9±6.6 岁。373 例患者行盆腔淋巴结清扫术。通过根治性前列腺切除术检测到局部进展和侵犯的病理 T 和 N 期癌症分别为 307 例和 22 例。共有 38 例接受辅助治疗的患者被排除在生化复发（BCR）后的进展分析之外，261 例男性发生了 BCR。共有 219 例患者接受了挽救性治疗。109 例患者发生局部复发，42 例患者发生远处转移；36 例患者发生局部复发和转移。22 例患者发生去势抵抗性前列腺癌，148 例患者发生总死亡率，23 例患者发生疾病特异性死亡率。从手术到 BCR、BCR 到转移以及转移到疾病特异性死亡的中位时间分别为 25、40 和 22 个月。
我们展示了韩国男性根治性前列腺切除术后局限性前列腺癌的长期预后。我们的结果与西方文献报道的结果不同，远处转移的发生率较低，BCR 后转移的时间也较短。
