Impact of the Proportion of Biopsy Positive Core in Predicting Biochemical Recurrence in Patients with Pathological Pt2 and Negative Resection Margin Status after Radical Prostatectomy
Impact of the Proportion of Biopsy Positive Core in Predicting Biochemical Recurrence in Patients with Pathological Pt2 and Negative Resection Margin Status after Radical Prostatectomy
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DOI：
10.1007/s12253-019-00762-6
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发表时间：
2020-10-01
影响因子：
2.8
通讯作者：
Ohyama, Chikara
中科院分区：
文献类型：
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作者：
Oikawa, Masaaki;Tanaka, Toshikazu;Ohyama, Chikara
本研究旨在探讨与前列腺癌根治术(RP)后生化复发(BCR)相关的预后因素。在这项回顾性研究中，我们检查了386名经RP治疗后rM为阴性的pt2PCa患者。肿瘤的长度是为每个活检核心提供的，而PCa的总百分比是由我们机构的病理学家计算的。我们估计了这些患者的无BCR生存期(BRFS)。采用COX比例风险模型进行单因素和多因素分析，以确定BCR的危险因素。参与者的中位年龄为68岁，他们的初始前列腺特异性抗原水平为6.55 ng/mL。中位随访期为85.7个月。受试者5年BRFS率为89.0%。活检Gleason评分为6分的患者5年无瘤生存率为89.8%，7分患者为90.4%，8分患者为64.1%(P=0.007)。活检阳性核心为21%的患者BRFS率为93.3%(P=0.001)。多因素分析显示，活检阳性核心率与BCR显著相关。活检阳性核心的比例可以预测pt2前列腺癌患者的术前协变量，而RP术后的RM状态为阴性。
This study aimed to determine the prognostic factors associated with biochemical recurrence (BCR) after radical prostatectomy (RP) in patients with pathological T2 (pT2) prostate cancer (PCa) and negative resection margin (RM) status at a single institution. In this retrospective study, we examined 386 patients who were diagnosed with pT2 PCa with negative RM after RP. The length of the tumor was provided for each biopsy core and the overall percentage of PCa was calculated by a pathologist at our institution. We estimated the BCR-free survival (BRFS) in these patients. Univariate and multivariate analyses were performed using the Cox proportional hazard model to determine the risk factors of BCR. The median age of the participants was 68 years, and their initial prostate-specific antigen level was 6.55 ng/mL. The median follow-up period was 85.7 months. The 5-year BRFS rate of the participants was 89.0%. The 5-year BRFS rates were 89.8% in patients with a biopsy Gleason score of 6, 90.4% in those with 7, and 64.1% in those with >= 8 (P = 0.007). The BRFS rate was 93.3% in patients who had a biopsy positive core = 21% (P = 0.001). Based on the multivariate analysis, the proportion of biopsy positive core was significantly associated with BCR. The proportion of biopsy positive core may predict preoperative covariates in patients with pT2 PCa and negative RM status after RP.