확대 전립선 생검을 통해 저위험성으로 확인된 국소전립선암의 근치적 전립선적출술 후 병리학적 결과

Abstract

PURPOSE: To investigate clinicopathologic characteristics of unilateral, low risk prostate cancers detected via multi(>or=12)-core prostate biopsy. MATERIALS AND METHODS: One hundred four patients who underwent radical retropubic prostatectomy(RRP) for unilateral, low risk prostate cancer (clinical stage <or=T2a, biopsy Gleason sum <or=6, PSA <or=10ng/ml, and ipsilateral positive cores <or=2) detected via multi (>or=12)-core prostate biopsy were enrolled. In this retrospective study, we reviewed the patients' preoperative and pathologic data to assess potential predictors of pT2c or greater disease at the time of RRP, as well as characteristics of such disease. RESULTS: Of the 104 subjects, only 34(32.7%) were pathologically-proven to have unilateral disease, while the others showed pathologically-bilateral or worse disease from analysis of the RRP specimens. Subjects pathologically found to have uni- and bi-lateral disease showed no significant differences regarding age, prostate-specific antigen(PSA), free-to-total PSA ratio, prostate volume, clinical stage, number of positive cores, biopsy Gleason score, number of total biopsy sites, and highest percentage of tumor at any biopsy site. Multivariate logistic regression analysis revealed no significant preoperative predictors of pT2c or greater disease at RRP. CONCLUSIONS: Most patients with unilateral, low risk prostate cancer detected on multi(>or=12)-core prostate biopsy actually had pathologically- worse disease. For clinically-localized prostate cancer, a more accurate method to identify appropriate candidates for unilateral or focal ablative therapy should be developed.