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KMID : 0358320070480080797
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Korean Journal of Urology
2007 Volume.48 No. 8 p.797 ~ p.803
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A Study on the Incidence and Preoperative Predicting Factors of Extraprostatic Extension in T1c Prostate Cancers
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Jeong Seong-Jin
Chang In-Ho
Han Jun-Hyun
Yu Ji-Hyeong
Han Byoung-Kyu
Hong Sung-Kyu
Byun Seok-Soo
Lee Sang-Eun
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Abstract
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Purpose: To evaluate the incidence and identify the predicting factors of extraprostatic extension(EPE) in T1c prostate cancers.
Materials and Methods: Of 267 consecutive men who underwent radical retropubic prostatectomy(RRP) as initial treatment for prostate cancers, 131(49.1%) presented with a clinical stage T1c disease. Clinicopathological data were collected, and factors related to biopsy collected; i.e. the number of positive cores(No.(+) core); the percentage of positive cores(%(+) core); the maximal tumor length(Max. mm cancer); the sum of tumor length (Total mm cancer); the maximal ratio of tumor/core length(Max. % mm cancer) and the mean ratio of tumor/core length(Mean % mm cancer). A logistical regression analysis was performed after dividing the cases into organ-confined(OC) and EPE.
Results: Of the T1c tumors, 107(81.7%) and 24(18.3%) were found to be OC and to have EPE after RRP, respectively. The preoperative factors that showed a significant difference between the two groups(OC vs. EPE) were %free prostate-specific antigen(17.7 vs. 11.1%), prostate volume(43.5 vs. 34.6ml), Gleason score(6.4 vs. 6.8), %(+) core(17.9 vs. 27%), Max. mm cancer(3.5 vs. 6.7mm) and Max. % mm cancer(24.0 vs. 41.6%). Of these factors, those significantly predicting EPE in the receiver operator characteristics curve were: the Gleason score, %(+) core, Max. mm cancer and Max. % mm cancer. Of these, only the %(+) core and Max. mm cancer were significant in predicting EPE in the multivariate logistical regression. When the cutoff of %(+) core was 19%, the risk of EPE increased 2.3 times, and when the cutoff of Max. mm cancer was 5mm the risk increased 3.6 times.
Conclusions: Max. mm cancer and %(+) core during a biopsy are preoperative factors that predict the EPE of a clinical stage T1c disease, and should be considered for modifying the surgical technique and in establishing treatment plans.
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KEYWORD
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Prostate cancer, Extraprostatic extension, Prostatectomy
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