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Time to Disease Recurrence Is a Predictor of Metastasis and Mortality in Patients with High-risk Prostate Cancer Who Achieved Undetectable Prostate-specific Antigen Following Robot-assisted Radical Prostatectomy

DC FieldValueLanguage
dc.contributor.author구교철-
dc.contributor.author김도경-
dc.contributor.author나군호-
dc.contributor.author이광석-
dc.contributor.author정병하-
dc.contributor.author하윤수-
dc.contributor.author홍성준-
dc.date.accessioned2019-01-15T17:09:09Z-
dc.date.available2019-01-15T17:09:09Z-
dc.date.issued2018-
dc.identifier.issn1011-8934-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/166834-
dc.description.abstractBackground: Robot-assisted radical prostatectomy (RARP) is a feasible treatment option for high-risk prostate cancer (PCa). While patients may achieve undetectable prostate-specific antigen (PSA) levels after RARP, the risk of disease progression is relatively high. We investigated metastasis-free survival, cancer-specific survival (CSS), and overall survival (OS) outcomes and prognosticators in such patients. Methods: In a single-center cohort of 342 patients with high-risk PCa (clinical stage ≥ T3, biopsy Gleason score ≥ 8, and/or PSA levels ≥ 20 ng/mL) treated with RARP and pelvic lymph node dissection between August 2005 and June 2011, we identified 251 (73.4%) patients (median age, 66.5 years; interquartile range [IQR], 63.0-71.0 years) who achieved undetectable PSA levels (< 0.01 ng/mL) postoperatively. Survival outcomes were evaluated for the entire study sample and in groups stratified according to the time to biochemical recurrence dichotomized at 60 months. Results: During the median follow-up of 75.9 months (IQR, 59.4-85.8 months), metastasis occurred in 38 (15.1%) patients, most often to the bones, followed by the lymph nodes, lungs, and liver. The 5-year metastasis-free, cancer-specific, and OS rates were 87.1%, 94.8%, and 94.3%, respectively. Multivariate Cox-regression analysis revealed time to recurrence as an independent predictor of metastasis (P < 0.001). Time to metastasis was an independent predictor of OS (P = 0.003). Metastasis-free and CSS rates were significantly lower among patients with recurrence within 60 months of RARP (log-rank P < 0.001). Conclusion: RARP confers acceptable oncological outcomes for high-risk PCa. Close monitoring beyond 5 years is warranted for early detection of disease progression and for timely adjuvant therapy.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisher대한의학회(The Korean Academy of Medical Sciences)-
dc.relation.isPartOfJOURNAL OF KOREAN MEDICAL SCIENCE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleTime to Disease Recurrence Is a Predictor of Metastasis and Mortality in Patients with High-risk Prostate Cancer Who Achieved Undetectable Prostate-specific Antigen Following Robot-assisted Radical Prostatectomy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Urology (비뇨의학교실)-
dc.contributor.googleauthorDo Kyung Kim-
dc.contributor.googleauthorKyo Chul Koo-
dc.contributor.googleauthorKwang Suk Lee-
dc.contributor.googleauthorYoon Soo Hah-
dc.contributor.googleauthorKoon Ho Rha-
dc.contributor.googleauthorSung Joon Hong-
dc.contributor.googleauthorByung Ha Chung-
dc.identifier.doi10.3346/jkms.2018.33.e285-
dc.contributor.localIdA00188-
dc.contributor.localIdA05453-
dc.contributor.localIdA05453-
dc.contributor.localIdA01227-
dc.contributor.localIdA01227-
dc.contributor.localIdA02668-
dc.contributor.localIdA02668-
dc.contributor.localIdA03607-
dc.contributor.localIdA03607-
dc.contributor.localIdA05526-
dc.contributor.localIdA05526-
dc.contributor.localIdA04402-
dc.contributor.localIdA04402-
dc.relation.journalcodeJ01517-
dc.identifier.eissn1598-6357-
dc.identifier.pmid30402050-
dc.subject.keywordProstate Cancer-
dc.subject.keywordProstatectomy-
dc.subject.keywordRecurrence-
dc.subject.keywordSurvival-
dc.contributor.alternativeNameKoo, Kyo Chul-
dc.contributor.affiliatedAuthor구교철-
dc.contributor.affiliatedAuthor김도경-
dc.contributor.affiliatedAuthor김도경-
dc.contributor.affiliatedAuthor나군호-
dc.contributor.affiliatedAuthor나군호-
dc.contributor.affiliatedAuthor이광석-
dc.contributor.affiliatedAuthor이광석-
dc.contributor.affiliatedAuthor정병하-
dc.contributor.affiliatedAuthor정병하-
dc.contributor.affiliatedAuthor하윤수-
dc.contributor.affiliatedAuthor하윤수-
dc.contributor.affiliatedAuthor홍성준-
dc.contributor.affiliatedAuthor홍성준-
dc.citation.volume33-
dc.citation.number45-
dc.citation.startPagee285-
dc.identifier.bibliographicCitationJOURNAL OF KOREAN MEDICAL SCIENCE, Vol.33(45) : e285, 2018-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers

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