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Outcomes of pathologically localized high-grade prostate cancer treated with radical prostatectomy

 Ji Eun Heo  ;  Jee Soo Park  ;  Jong Soo Lee  ;  Jongchan Kim  ;  Won Sik Jang  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Sung Joon Hong  ;  Won Sik Ham 
 MEDICINE, Vol.98(42) : e17627, 2019 
Journal Title
Issue Date
Aged ; Cause of Death/trends ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Grading/methods* ; Prognosis ; Prostate/pathology* ; Prostate/surgery ; Prostatectomy/methods* ; Prostatic Neoplasms/diagnosis* ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/surgery ; Republic of Korea/epidemiology ; Retrospective Studies ; Survival Rate/trends
Adjuvant radiation therapy (ART) is recommended without consideration of radical prostatectomy Gleason score (RP GS) for cases with adverse features. We compared the outcomes of pathologically localized high-grade (GS 8-10) prostate cancer (PC) with those of pT3 GS 7 PC.A total of 1585 men who underwent RP between 1995 and 2015 comprised the cohort, which was divided into group 1 (RP GS 7(3 + 4) and pT3; n = 760), group 2 (RP GS 7(4 + 3) and pT3; n = 565), and group 3 (RP GS 8-10 and pT2; n = 260). Biochemical recurrence (BCR), all-cause mortality (ACM), and PC-specific mortality (PCSM) risk were compared among groups using Cox regression and competing risk analysis.At a median follow-up of 58 months (interquartile range: 37-85), 721 men experienced BCR and 84 died (22 due to PC). BCR-free survival rates were lower in group 3 than in group 1 (P < .001); nevertheless, no difference was observed between groups 2 and 3 (P = .638). Furthermore, no difference in ACM was noted among groups. PCSM rates were higher in group 3 than in groups 1 and 2 (P = .001 and P = .005, respectively). This association persisted in multivariate models after adjustment for clinicopathological variables.Patients with RP GS 8-10 and pT2 PC had higher BCR and PCSM rates than those with RP GS 7 and pT3 PC. Localized high-grade PC should be considered in decision-making for ART.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Chan(김종찬) ORCID logo https://orcid.org/0000-0002-0022-6689
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Park, Jee Soo(박지수) ORCID logo https://orcid.org/0000-0001-9976-6599
Lee, Jong Soo(이종수) ORCID logo https://orcid.org/0000-0002-9984-1138
Jang, Won Sik(장원식) ORCID logo https://orcid.org/0000-0002-9082-0381
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
Heo, Ji Eun(허지은) ORCID logo https://orcid.org/0000-0002-4184-8468
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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