전립선암으로 근치적 전립선적출술을 받은 한국인의 특징과 예후

Abstract

Purpose: There is a great difference between the prostate cancer in Asian men compared to Western men. We evaluated the clinicopathologic features and prognosis of Korean men with prostate cancer who underwent radical prostatectomy.

Materials and Methods : We reviewed retrospectively the clinicopathologic parameters including age, preoperative PSA, stage, Gleason score and so on in 2,783 men underwent radical prostatectomy in 14 institutions. Of 2,783 men, patients with prior radiotherapy, neoadjuvant treatment, suspicious lymph node invasion, distant metastasis and treatment failure were excluded. We evaluated recent change in clinical parameters. 2,081 men with localized prostate cancer were analyzed for the biochemical recurrence-free survival rates.

Results: Proportion of patients with serum PSA of less than 10ng/ml were 38.9% in 1999. However the proportion were 68.6% in 2008. The 5-year overall biochemical recurrence-free survival rate (BCR-FS) was 48%. The 5-year BCR-FS according to the preoperative serum PSA, biopsy Gleason score, pathologic T stage, margin positivity had the lower level than Western series.

Conclusions : The proportion of patients with serum PSA ＜10ng/ml were increased in Korean men with prostate cancer. However, the BCR-FS had the lower level than Western men. Therefore, we must consider that the prostate cancer in Korean men have a unfavorable prognosis compared with Western men