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KMID : 0358320070480060592
Korean Journal of Urology
2007 Volume.48 No. 6 p.592 ~ p.597
Efficacy of Radical Retropubic Prostatectomy in Patients with Clinically Localized Prostate Cancer and a Biopsy Gleason Score of 8 or Higher
Han Jun-Hyun

Chang In-Ho
Yu Ji-Hyeong
Han Byoung-Kyu
Jeong Seong-Jin
Hong Sung-Kyu
Byun Seok-Soo
Lee Sang-Eun
Abstract
Purpose: We retrospectively reviewed clinicopathological characteristics in patients who underwent radical retropubic prostatectomy(RRP) with clinically localized prostate cancer and a biopsy Gleason score of 8 or higher.
Materials and Methods: Among 266 patients who underwent RRP without prior any neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a biopsy Gleason score of 8 or higher. We analyzed several clinicopathologic factors that predict organ-confined disease, and also investigated the impact on postoperative changes of the biopsy Gleason score.

Results: Of 29 patients, 12(41.4%) had organ-confined cancer. Serum prostate-specific antigen(PSA), prostate-specific antigen density(PSAD), tumor volume, and tumor percentage were significant factors for predicting organ-confined cancer(p£¼0.05). The number of the positive core, percentage of the positive core, sum of the tumor length of the positive core, tumor percentage of total core length, and tumor percentage of the positive core length were also significantly higher in the group with an extraprostatic extension compared to the organ-confined cancer group (p£¼0.05). Of 29 patients, 14(48.3%) were downgraded to a Gleason score of 7 or less and had a higher chance(64.3%; p=0.016) of experiencing organ- confined disease than those that remained at Gleason scores of 8-10.

Conclusions: Among patients with clinical localized prostate cancer and a biopsy Gleason score of 8 or higher, radical prostatectomy can be considered for primary treatment in some cases with low PSA and PSAD and low predictive volume of the tumor from biopsy results. (Korean J Urol 2007;48:592-597)
KEYWORD
Prostatectomy, Biopsy, Prostatic neoplasms
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