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KMID : 0358320070480020125
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Korean Journal of Urology
2007 Volume.48 No. 2 p.125 ~ p.130
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Clinico-pathological Characteristics of Prostate Cancer in Korean Men and Nomograms for the Prediction of the Pathological Stage of the Clinically Localized Prostate Cancer: A Multi-institutional Update
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Song Cheryn
Kang Tae-jin
Lee Moo-Song
Ro Jae Y.
Lee Sang-Eun
Lee Eun-Sik
Choi Han-Yong
Han Deok-Hyun
Hong Sung-Joon
Chung Byung-Ha
Kim Choung-Soo
Ahn Han-Jong
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Abstract
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Purpose: In this multi institutional study, the data of 604 men with clinically localized prostate cancer, who underwent radical prostatectomy, with updated nomograms predicting the pathological stage, were analyzed.
Materials & Methods: Prostate biopsies and prostatectomy specimens from men treated with radical prostatectomy, obtained between 1990 and 2003, were included. The patient distribution with respect to clinical stage, serum prostate-specific antigen(PSA) and biopsy Gleason score, as well as final pathological findings, including organ-confined disease(OCD), extracapsular extension(ECE), seminal vesicle invasion(SVI), and lymph node metastasis(LNM), were analyzed for the construction of nomograms representing the percent probabilities of each respective pathological outcome.
Results: The median serum PSA at the time of surgery and biopsy Gleason score were 9.9ng/ml and 7, respectively. The preoperative serum PSA was 4ng/ml or less in 38(6.3%) patients and the tumor was impalpable in 292 (48.2%) of patients. The biopsy Gleason scores were 7 and 8 or higher in 186(30.7%) and 169(27.9%), respectively. Throughout the clinical stages and PSA ranges, the Gleason score was 7 or higher in more than 50% of patients, but 8-10 in 20-30%. The overall OCD, ECE, SVI and LNM rates were 57.1, 27.8, 10.9 and 4.2%, respectively.
Conclusion: A significantly high proportion of prostate cancers arising in Korean men exhibited poor differentiation, with Gleason scores of 7 or higher, regardless of the clinical stage or initial serum PSA. Updated nomograms acknowledging such characteristics have been developed, which may aid in the treatment planning of these individuals. (Korean J Urol 2007;48:125-130)
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KEYWORD
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Prostate neoplasm, Prostatectomy, Nomograms
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