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

Authors
 Ho Won Kang  ;  Hae Do Jung  ;  Joo Yong Lee  ;  Jong Kyou Kwon  ;  Seong Uk Jeh  ;  Kang Su Cho  ;  Won Sik Ham  ;  Young Deuk Choi 
Citation
 ASIAN JOURNAL OF SURGERY, Vol.42(1) : 120-125, 2019 
Journal Title
ASIAN JOURNAL OF SURGERY
ISSN
 1015-9584 
Issue Date
2019
MeSH
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*
Keywords
Prostatectomy ; Prostatic neoplasms ; Robotics ; Treatment outcome
Abstract
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.
Files in This Item:
T201900214.pdf Download
DOI
10.1016/j.asjsur.2017.10.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Jung, Hae Do(정해도)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167624
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