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Pathological and oncological features of Korean prostate cancer patients eligible for active surveillance: analysis from the K-CaP registry

Authors
 Kyo Chul Koo  ;  Kwang Suk Lee  ;  Jae Yong Jeong  ;  In Young Choi  ;  Ji Youl Lee  ;  Jun Hyuk Hong  ;  Choung-Soo Kim  ;  Hyun Moo Lee  ;  Sung Kyu Hong  ;  Seok-Soo Byun  ;  Seung Hwan Lee  ;  Koon Ho Rha  ;  Byung Ha Chung 
Citation
 Japanese Journal of Clinical Oncology, Vol.47(10) : 981-985, 2017 
Journal Title
 Japanese Journal of Clinical Oncology 
ISSN
 0368-2811 
Issue Date
2017
MeSH
Aged ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen/metabolism* ; Prostatectomy/methods* ; Prostatic Neoplasms/diagnosis* ; Prostatic Neoplasms/pathology ; Registries
Keywords
prostate cancer ; prostate-specific antigen ; surveillance
Abstract
Background: A web-based multicenter Korean Prostate Cancer Database (K-CaP) was established to provide urologists with information on Korean prostate cancer (PCa) patients treated with radical prostatectomy (RP). We utilized the K-CaP registry to identify pathological features and oncological outcomes of Korean PCa patients eligible for active surveillance (AS). Methods: The K-CaP registry consisted of 6415 patients who underwent RP from May 2001 to April 2013 at five institutions. Preoperative clinicopathological data were collected to identify patients who were eligible for at least one contemporary AS protocol. Patients who had received neoadjuvant androgen deprivation therapy or a 5α-reductase inhibitor, who had <10 total biopsy cores, or who had incomplete data were excluded. Biochemical recurrence (BCR) was defined as prostate-specific antigen (PSA) level ≥0.2 ng/ml following RP. Results: A total of 560 patients were identified, and the median follow-up period was 52.0 (interquartile range, 39.0-67.3) months. Pathologically insignificant PCa, defined as organ-confined disease with Gleason score ≤6 was observed in 314 (56.1%) patients. Pathological upgrading (Gleason score ≥7) and upstaging (≥pT3) were observed in 237 (42.3%) and 75 (13.4%) patients, respectively. Unfavorable disease (extracapsular extension, seminal vesicle invasion, or Gleason score ≥8) was observed in 85 (15.2%) patients. PSA density ≤0.2 ng/ml/cc and maximal single core involvement ≤20% were revealed as independent preoperative predictors of pathologically insignificant PCa. Conclusion: Contemporary Western AS protocols unreliably predict pathologically insignificant PCa in Korean men. Korean men may harbor more aggressive PCa features than Western men, and thus, a more stringent AS protocol is needed.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161180
DOI
10.1093/jjco/hyx101
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
구교철(Koo, Kyo Chul) ; 나군호(Rha, Koon Ho) ; 이광석(Lee, Kwang Suk) ; 이승환(Lee, Seung Hwan) ; 정병하(Chung, Byung Ha)
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Full Text
https://academic.oup.com/jjco/article/47/10/981/3979097
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