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Evaluation of the 7th American Joint Committee on Cancer TNM Staging System for Prostate Cancer in Point of Classification of Bladder Neck Invasion

Authors
 Mun Su Chung  ;  Seung Hwan Lee  ;  Dong Hoon Lee  ;  Byung Ha Chung 
Citation
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY, Vol.43(2) : 184-188, 2013 
Journal Title
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY 
ISSN
 0368-2811 
Issue Date
2013
MeSH
Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Biomarkers, Tumor/blood ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Male ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Staging ; Neoplasm, Residual ; Odds Ratio ; Proportional Hazards Models ; Prostate-Specific Antigen/blood ; Prostatectomy* ; Prostatic Neoplasms/immunology ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery ; Reproducibility of Results ; Republic of Korea ; Urinary Bladder Neoplasms/immunology ; Urinary Bladder Neoplasms/pathology*
Keywords
prostatic neoplasms ; prostatectomy ; bladder ; neoplasm staging
Abstract
OBJECTIVE: To assess the validity of the 7th edition of the American Joint Committee on Cancer TNM staging system for prostate cancer, paying special attention to bladder neck invasion, in an Asian population. METHODS: Clinicopathologic data of 368 men who underwent radical prostatectomy between 2003 and 2011 at our institution were reviewed. The main interest of this study was to confirm that both isolated positive bladder neck margin and positive bladder neck margin associated with other surgical margin have more favorable biochemical outcomes than seminal vesicle invasion (pT3b). RESULTS: The 3-year biochemical recurrence-free survival for men with organ confined disease, extraprostatic extension, isolated positive bladder neck margin, positive bladder neck margin with other surgical margin and seminal vesicle invasion was 88.9, 74.8, 51.2, 19.4 and 18.8%, respectively. On multivariate analysis, the increased risk of progression associated with an isolated positive bladder neck margin (hazard ratio 4.34, 95% confidence interval 1.40-13.46, P = 0.011) was less than that of seminal vesicle invasion (hazard ratio 9.67, 95% confidence interval 3.70-25.25, P < 0.001). As for the positive bladder neck margin with other surgical margin, the increased risk of progression (hazard ratio 9.32, 95% confidence interval 3.50-24.82, P < 0.001) was similar to that of men with seminal vesicle invasion. CONCLUSIONS: In our study, men with isolated positive bladder neck margin and positive bladder neck margin plus other surgical margin had no worse biochemical outcomes than those with seminal vesicle invasion (pT3b). It is reasonable to classify prostate cancer with bladder neck invasion (the 6th American Joint Committee on Cancer edition pT4 category) into the 7th edition pT3 category.
Files in This Item:
T201300379.pdf Download
DOI
10.1093/jjco/hys196
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Dong Hoon(이동훈)
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86415
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