근치적 전립선적출술 후 발견된 다발성 전립선암의 예후적 가치
Prognostic Significance of Multifocal Tumor in Radical Prostatectomy

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정재승; 한병규; 정성진; 문기혁; 최기영; 박동수; 홍성규; 변석수; 이상은
Issue Date
The Korean Urological Associaton = 대한비뇨기과학회
Korean J Urol 2008;49:510-4
Prostate cancer; Multifocality; Recurrence
Purpose: We investigate the impact of tumor multifocality on the biochemical
recurrence rate after radical prostatectomy.
Materials and Methods: Data was collected from 525 patients who underwent
radical prostatectomy for clinically localized prostate cancer from
2003 to 2007. We evaluated the potential associations of multifocality with
various clinical and pathologic factors. The ability to predict extra-capsular
extension (ECE) was tested by logistic regression models, whereas biochemical
recurrence (BCR) was assessed via Kaplan-Meier analyses and
Cox-hazard regression models. The BCR was defined as a level of serum
prostate-specific antigen (PSA) of 0.2ng/ml or greater on consecutive
Results: Multifocality was observed to be significantly associated with the
presence of a high grade Gleason pattern (p=0.014), the pT stage (p<
0.001), ECE (p=0.005) and a positive surgical margin (PSM) (p=0.019).
Moreover, it was the independent predictor of ECE on multivariate logistic
regression analyses (p=0.039). However, although multifocality had a significant
influence on biochemical recurrence on the Kaplan-Meier analyses
(log rank test, p=0.019), only the PSA level and the Gleason score were
significant predictors of BCR on the multivariated Cox-hazard analyses.
Conclusions: Although multifocality was associated with adverse pathologic
features, it had no significant effect on biochemical recurrence on
the multivariated cox-hazard analyses.
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