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Predictors of adverse pathologic features after radical prostatectomy in low-risk prostate cancer

 Jae Won Park  ;  Dong Hoon Koh  ;  Won Sik Jang  ;  Kang Su Cho  ;  Won Sik Ham  ;  Koon Ho Rha  ;  Sung Joon Hong  ;  Young Deuk Choi 
 BMC Cancer, Vol.18(1) : 545, 2018 
Journal Title
 BMC Cancer 
Issue Date
Adverse pathologic features ; Low-risk prostate cancer ; Needle biopsy ; Radical prostatectomy
BACKGROUND: Prostate-specific antigen (PSA) screening more frequently detects early stage prostate cancer (PC). However, adverse pathologic features (APFs) after radical prostatectomy (RP) in low-risk PC occur. Previous related studies had utilized outdated staging criteria or small sample cohorts. In this study, we analyzed predictors of APFs after RP in low-risk PC using classification under the current criteria. MATERIALS AND METHODS: We retrospectively reviewed medical records of 546 low-risk PC patients who had undergone RP. Low-risk PC was defined as PC with clinical T1-T2a, Gleason score </= 6, and PSA levels < 10 ng/mL. Clinical and pathological parameters were analyzed to predict APFs. APFs were defined as extracapsular extension (ECE), seminal vesicle invasion (SVI), or positive surgical margins (PSM). We analyzed our data using univariable and multivariable logistic regression analyses, as well as receiver operator characteristics to predict APFs. RESULTS: Among 546 patients, ECE, SVI, and PSM were present in 199 (36.4%), 8 (1.5%), and 179 cases (32.8%), respectively. PSM had a significant correlation with preoperative high PSA levels and number of positive cores obtained. ECE/SVI was also significantly correlated with PSA levels and number of positive cores. As a result, presence of APFs after RP was associated with high PSA levels and large number of positive cores. PSA > 4.5 ng/mL and number of positive cores > 2 in low-risk PC were significantly associated with APFs, and suggested as cut-off values for predicting APFs. CONCLUSIONS: PSA > 4.5 ng/mL and number of positive cores > 2 in low-risk PC were associated with presence of APFs and patients with such records should be considered carefully to provide active surveillance.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
고동훈(Koh, Dong Hoon)
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
박재원(Park, Jae Won)
장원식(Jang, Won Sik) ORCID logo https://orcid.org/0000-0002-9082-0381
조강수(Cho, Kang Su) ORCID logo https://orcid.org/0000-0002-3500-8833
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
함원식(Ham, Won Sik) ORCID logo https://orcid.org/0000-0003-2246-8838
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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