KMID : 1001020130110030145
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Korean Journal of Urological Oncology 2013 Volume.11 No. 3 p.145 ~ p.151
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Predictors for Migrating to High-Risk Prostate Cancer from Intermediate-Risk Prostate Cancer in Korean Patients: Multicenter Study
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Ryu Je-Guk
Hwang In-Sang LIm Dong-Hoon Jeong Young-Beom Park Seung-Chol Noh Joon-Hwa Kwon Dong-Deuk Kang Taek-Won
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Abstract
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Purpose: We aimed to examine a change and relevant predictors in intermediate-risk prostate cancer which have a wide range of treatment options from active surveillance to radical prostatectomy (RP).
Materials and Methods: Of 1,159 patients who underwent RP in multi-institution between January 2009 and December 2012, 390 patients who were classified as intermediate-risk prostate cancer group by preoperative evaluation according to NCCN guideline were enrolled in this retrospective study. The rates of Gleason score upgrading, upstaging and migrating to high-risk prostate cancer group at final pathology and there risk factors were assessed.
Results: The mean age of enrolled patients were 67.33¡¾6.17 years with mean PSA level of 9.34¡¾4.34 ng/ml. The number of patients with worsening upgrading, worsening upstaging and worsening prognosis were 42 (10.77%), 83 (21.28%) and 108 (27.7%), respectively. In analysis compared between upgrading group and non-up-grading group, there was no difference in patient¡¯s features. However, in analysis on upstaging and worsening prognosis, serum PSA (p=0.029, p=0.042) and %positive biopsy core (p=0.010, p=0.013) showed significant diffe-rence. In univariable analysis, serum PSA (p=0.030, p=0.042) and %positive biopsy core (p=0.004, p=0.014) were predictive of upstaging and worsening prognosis, also, in multivariable analysis, serum PSA (p=0.016) and %positive biopsy core (p=0.042) were statistically relevant factors of worsening upstaging.
Conclusions: In this study, 27.7% of patients with preoperative intermediate-risk prostate cancer were re-stra-tified into high-risk prostate cancer group after RP. Serum PSA and %positive biopsy core were the predictive factors for migrating to high risk group.
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KEYWORD
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Prostate cancer, Biopsy, Prostatectomy, Gleason score
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