Korean J Urol.  2007 Jun;48(6):592-597. 10.4111/kju.2007.48.6.592.

Efficacy of Radical Retropubic Prostatectomy in Patients with Clinically Localized Prostate Cancer and a Biopsy Gleason Score of 8 or Higher

• Han JH
• Chang IH
• Yu JH
• Han BK
• Jeong SJ
• Hong SK
• Byun SS
• Lee SE

• KMID: 1885539
• DOI: http://doi.org/10.4111/kju.2007.48.6.592

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<0.05). 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 lngth were also significantly higher in the group with an extraprostatic extension compared to the organ-confined cancer group (p<0.05). 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.

Keyword

Prostatectomy; Biopsy; Prostatic neoplasms

MeSH Terms

Biopsy*
Humans
Neoadjuvant Therapy
Neoplasm Grading*
Prostate*
Prostate-Specific Antigen
Prostatectomy*
Prostatic Neoplasms*
Retrospective Studies
Tumor Burden
Prostate-Specific Antigen

Reference

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