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Prediction of organ-confined disease after robot-assisted radical prostatectomy in patients with clinically locally-advanced prostate cancer

 Ho Won Kang  ;  Hae Do Jung  ;  Joo Yong Lee  ;  Jong Kyou Kwon  ;  Seong Uk Jeh  ;  Kang Su Cho  ;  Won Sik Ham  ;  Young Deuk Choi 
 Asian Journal of Surgery, Vol.42(1) : 120-125, 2019 
Journal Title
 Asian Journal of Surgery 
Issue Date
Aged ; Biomarkers/blood ; Biopsy, Large-Core Needle ; Cohort Studies ; Forecasting ; Humans ; Logistic Models ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Grading ; Neoplasm Staging ; Preoperative Care ; Prognosis ; Prostate-Specific Antigen ; Prostatectomy/methods* ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery* ; Retrospective Studies ; Robotic Surgical Procedures/methods*
Prostatectomy ; Prostatic neoplasms ; Robotics ; Treatment outcome
BACKGROUND: Little is known about the preoperative predictive factors that could identify subsets of favorable patients who can be possibly cured with robot-assisted radical prostatectomy (RARP) alone in locally advanced prostate cancer (LAPCa). Our study was designed to identify clinical predictors of pathologic organ-confined disease (pOCD) in RARP setting. METHODS: Between 2007 and 2013, clinicopathological and oncological data from 273 consecutive men undergoing robot-assisted RP with extended PLND for clinically LAPCa were reviewed in a single-institution, retrospectively. After exclusion of patients who received neoadjuvant hormone treatment before surgery, 186 subjects satisfied the final inclusion criteria. RESULTS: Fourty-three patients (23.1% of total cohort) with preoperative clinically LAPCa patients were down-staged to pOCD following RARP. Preoperative prostate-specific antigen (PSA) level, preoperative PSAD, positive core percent, maximal tumor volume in any core, and biopsy Gleason score were significantly associated with down-staging into pOCD following RARP. Multivariate logistic regression analysis revealed that lower preoperative PSA (≤10 ng/mL) and maximal tumor volume in any core (≤70%) were independent predictors of pOCD following RARP. CONCLUSIONS: Approximately 23% of preoperative clinically LAPCa patients were down-staged to pOCD following RARP. Preoperative PSA and maximal tumor volume in any biopsy core might be useful clinical predictors of pOCD in clinically LAPCa patients in RARP setting.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
이주용(Lee, Joo Yong) ORCID logo https://orcid.org/0000-0002-3470-1767
정해도(Jung, Hae Do)
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
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