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Genitourinary cancer
Bilateral Seminal Vesicle Invasion as a Strong Prognostic Indicator in T3b Prostate Cancer Patients Following Radical Prostatectomy: A Comprehensive, Multicenter, Long-term Follow-up Study
Jungyo Suh, In Gab Jeong, Hwang Gyun Jeon, Chang Wook Jeong, Sangchul Lee, Seong Soo Jeon, Seok-Soo Byun, Cheol Kwak, Hanjong Ahn
Cancer Res Treat. 2024;56(3):885-892.   Published online January 5, 2024
DOI: https://doi.org/10.4143/crt.2023.1264
AbstractAbstract PDFPubReaderePub
Purpose
Pathologic T3b (pT3b) prostate cancer, characterized by seminal vesicle invasion (SVI), exhibits variable oncological outcomes post–radical prostatectomy (RP). Identifying prognostic factors is crucial for patient-specific management. This study investigates the impact of bilateral SVI on prognosis in pT3b prostate cancer.
Materials and Methods
We evaluated the medical records of a multi-institutional cohort of men who underwent RP for prostate cancer with SVI between 2000 and 2012. Univariate and multivariable analyses were performed using Kaplan-Meier analysis and covariate-adjusted Cox proportional hazard regression for biochemical recurrence (BCR), clinical progression (CP), and cancer-specific survival (CSS).
Results
Among 770 men who underwent RP without neo-adjuvant treatment, median follow-up was 85.7 months. Patients with bilateral SVI had higher preoperative prostate-specific antigen levels and clinical T category (all p < 0.001). Extracapsular extension, tumor volume, lymph node metastasis (p < 0.001), pathologic Gleason grade group (p < 0.001), and resection margin positivity (p < 0.001) were also higher in patients with bilateral SVI. The 5-, 10-, and 15-year BCR-free survival rates were 23.9%, 11.7%, and 8.5%; CP-free survival rates were 82.8%, 62.5%, and 33.4%; and CSS rates were 96.4%, 88.1%, and 69.5%, respectively. The bilateral SVI group demonstrated significantly lower BCR-free survival rates, CP-free survival rates, and CSS rates (all p < 0.001). Bilateral SVI was independently associated with BCR (hazard ratio, 1.197; 95% confidence interval, p=0.049), CP (p=0.022), and CSS (p=0.038) in covariate-adjusted Cox regression.
Conclusion
Bilateral SVI is a robust, independent prognostic factor for poor oncological outcomes in pT3b prostate cancer.

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  • Role of [18F]-PSMA-1007 PET radiomics for seminal vesicle invasion prediction in primary prostate cancer
    Liang Luo, Xinyi Wang, Hongjun Xie, Hua Liang, Jungang Gao, Yang Li, Yuwei Xia, Mengmeng Zhao, Feng Shi, Cong Shen, Xiaoyi Duan
    Computers in Biology and Medicine.2024; 183: 109249.     CrossRef
  • 3,861 View
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A Nationwide Study of Differences in Surgical Treatment Rates and Oncological Outcomes for Prostate Cancer according to Economic Status and Region
Sangjun Yoo, Sohee Oh, Min Chul Cho, Hwancheol Son, Hyeon Jeong
Cancer Res Treat. 2023;55(2):652-658.   Published online December 12, 2022
DOI: https://doi.org/10.4143/crt.2022.893
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We investigated the effects of economic status (classified based on insurance type and residential area) on oncological outcomes of prostate cancer using a nationwide database. We additionally investigated oncological outcomes based on economic status and residential area in patients who underwent surgical treatment.
Materials and Methods
The study included 75,518 men with newly diagnosed prostate cancer between 2009 and 2018 in whom oncological outcomes were investigated based on economic status and residential area. Among the 75,518 men with prostate cancer, the data of 29,973 men who underwent radical prostatectomy were further analyzed. Multivariate analysis was performed to determine the effects of economic status and residential area on postoperative oncological outcomes.
Results
Among the 75,518 patients with prostate cancer, 3,254 (4.31%) were medical aid beneficiaries. The 5-year overall survival rates were 81.2% and 64.8% in the health insurance and medical aid groups, respectively. Radical prostatectomy was more common in the health insurance group, and surgical intervention was significantly affected by the residential area. Among patients who underwent surgery, 5-year androgen deprivation therapy–free and overall survival were better in the health insurance group. Multivariate analysis showed that insurance type and residential area were significantly associated with the androgen deprivation therapy–free and overall survival after adjustment for other variables.
Conclusion
Economic status and residential area were shown to affect not only treatment patterns but also post-diagnosis and postoperative oncological outcomes. Political support for early diagnosis and appropriate treatment of prostate cancer is warranted for medically vulnerable populations.
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Optimal Definition of Biochemical Recurrence in Patients Who Receive Salvage Radiotherapy Following Radical Prostatectomy for Prostate Cancer
Sung Uk Lee, Jae-Sung Kim, Young Seok Kim, Jaeho Cho, Seo Hee Choi, Taek-Keun Nam, Song Mi Jeong, Youngkyong Kim, Youngmin Choi, Dong Eun Lee, Won Park, Kwan Ho Cho
Cancer Res Treat. 2022;54(4):1191-1199.   Published online December 7, 2021
DOI: https://doi.org/10.4143/crt.2021.985
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study proposed the optimal definition of biochemical recurrence (BCR) after salvage radiotherapy (SRT) following radical prostatectomy for prostate cancer.
Materials and Methods
Among 1,117 patients who had received SRT, data from 205 hormone-naïve patients who experienced post-SRT prostate-specific antigen (PSA) elevation were included in a multi-institutional database. The primary endpoint was to determine the PSA parameters predictive of distant metastasis (DM). Absolute serum PSA levels and the prostate-specific antigen doubling time (PSA-DT) were adopted as PSA parameters.
Results
When BCR was defined based on serum PSA levels ranging from 0.4 ng/mL to nadir+2.0 ng/mL, the 5-year probability of DM was 27.6%-33.7%. The difference in the 5-year probability of DM became significant when BCR was defined as a serum PSA level of 0.8 ng/ml or higher (1.0-2.0 ng/mL). Application of a serum PSA level of ≥ 0.8 ng/mL yielded a c-index value of 0.589. When BCR was defined based on the PSA-DT, the 5-year probability was 22.7%-39.4%. The difference was significant when BCR was defined as a PSA-DT ≤ 3 months and ≤ 6 months. Application of a PSA-DT ≤ 6 months yielded the highest c-index (0.660). These two parameters complemented each other; for patients meeting both PSA parameters, the probability of DM was 39.5%-44.5%; for those not meeting either parameter, the probability was 0.0%-3.1%.
Conclusion
A serum PSA level > 0.8 ng/mL was a reasonable threshold for the definition of BCR after SRT. In addition, a PSA-DT ≤ 6 months was significantly predictive of subsequent DM, and combined application of both parameters enhanced predictability.

Citations

Citations to this article as recorded by  
  • New Prostate MRI Scoring Systems (PI-QUAL, PRECISE, PI-RR, and PI-FAB): AJR Expert Panel Narrative Review
    Adriano Basso Dias, Silvia D. Chang, Fiona M. Fennessy, Soleen Ghafoor, Sangeet Ghai, Valeria Panebianco, Andrei S. Purysko, Francesco Giganti
    American Journal of Roentgenology.2024;[Epub]     CrossRef
  • A Prospective Randomized Multicenter Study on the Impact of [18F]F-Choline PET/CT Versus Conventional Imaging for Staging Intermediate- to High-Risk Prostate Cancer
    Laura Evangelista, Fabio Zattoni, Marta Burei, Daniele Bertin, Eugenio Borsatti, Tanja Baresic, Mohsen Farsad, Emanuela Trenti, Mirco Bartolomei, Stefano Panareo, Luca Urso, Giuseppe Trifirò, Elisabetta Brugola, Franca Chierichetti, Davide Donner, Lucia S
    Journal of Nuclear Medicine.2024; 65(7): 1013.     CrossRef
  • Comparison of the Effects of DOTA and NOTA Chelators on 64Cu-Cudotadipep and 64Cu-Cunotadipep for Prostate Cancer
    Inki Lee, Min Hwan Kim, Kyongkyu Lee, Keumrok Oh, Hyunwoo Lim, Jae Hun Ahn, Yong Jin Lee, Gi Jeong Cheon, Dae Yoon Chi, Sang Moo Lim
    Diagnostics.2023; 13(16): 2649.     CrossRef
  • 6,470 View
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  • 2 Web of Science
  • 3 Crossref
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Clinical Outcomes of Postoperative Radiotherapy Following Radical Prostatectomy in Patients with Localized Prostate Cancer: A Multicenter Retrospective Study (KROG 18-01) of a Korean Population
Sung Uk Lee, Kwan Ho Cho, Won Park, Won Kyung Cho, Jae-Sung Kim, Chan Woo Wee, Young Seok Kim, Jin Ho Kim, Taek-Keun Nam, Jaeho Cho, Song Mi Jeong, Youngkyong Kim, Su Jung Shim, Youngmin Choi, Jun-Sang Kim
Cancer Res Treat. 2020;52(1):167-180.   Published online June 25, 2019
DOI: https://doi.org/10.4143/crt.2019.126
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to investigate the clinical outcomes of postoperative radiotherapy (PORT) patients who underwent radical prostatectomy for localized prostate cancer.
Materials and Methods
Localized prostate cancer patients who received PORT after radical prostatectomy between 2001 and 2012 were identified retrospectively in a multi-institutional database. In total, 1,117 patients in 19 institutions were included. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ≥ nadir+2 after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA regardless of its value.
Results
Ten-year biochemical failure-free survival, clinical failure-free survival, distant metastasisfree survival, overall survival (OS), and cause-specific survival were 60.5%, 76.2%, 84.4%, 91.1%, and 96.6%, respectively, at a median of 84 months after PORT. Pre-PORT PSA ≤ 0.5 ng/ml and Gleason’s score ≤ 7 predicted favorable clinical outcomes, with 10-year OS rates of 92.5% and 94.1%, respectively. The 10-year OS rate was 82.7% for patients with a PSA > 1.0 ng/mL and 86.0% for patients with a Gleason score of 8-10. The addition of longterm ADT (≥ 12 months) to PORT improved OS, particularly in those with a Gleason score of 8-10 or ≥ T3b.
Conclusion
Clinical outcomes of PORT in a Korean prostate cancer population were very similar to those in Western countries. Lower Gleason score and serum PSA level at the time of PORT were significantly associated with favorable outcomes. Addition of long-term ADT (≥ 12 months) to PORT should be considered, particularly in unfavorable risk patients with Gleason scores of 8-10 or ≥ T3b.

Citations

Citations to this article as recorded by  
  • Optimal Definition of Biochemical Recurrence in Patients Who Receive Salvage Radiotherapy Following Radical Prostatectomy for Prostate Cancer
    Sung Uk Lee, Jae-Sung Kim, Young Seok Kim, Jaeho Cho, Seo Hee Choi, Taek-Keun Nam, Song Mi Jeong, Youngkyong Kim, Youngmin Choi, Dong Eun Lee, Won Park, Kwan Ho Cho
    Cancer Research and Treatment.2022; 54(4): 1191.     CrossRef
  • A discussion on controversies and ethical dilemmas in prostate cancer screening
    Satish Chandra Mishra
    Journal of Medical Ethics.2021; 47(3): 152.     CrossRef
  • Clinical Outcome of Salvage Radiotherapy for Locoregional Clinical Recurrence After Radical Prostatectomy
    Sung Uk Lee, Kwan Ho Cho, Jin Ho Kim, Young Seok Kim, Taek-Keun Nam, Jae-Sung Kim, Jaeho Cho, Seo Hee Choi, Su Jung Shim, Jin Hee Kim, Ah Ram Chang
    Technology in Cancer Research & Treatment.2021;[Epub]     CrossRef
  • 7,929 View
  • 209 Download
  • 3 Web of Science
  • 3 Crossref
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Health-Related Quality of Life Changes in Prostate Cancer Patients after Radical Prostatectomy: A Longitudinal Cohort Study
Dong Wook Shin, Sang Hyub Lee, Tae-Hwan Kim, Seok Joong Yun, Jong Kil Nam, Seung Hyun Jeon, Seung Chol Park, Seung Il Jung, Jong-Hyock Park, Jinsung Park
Cancer Res Treat. 2019;51(2):556-567.   Published online July 16, 2018
DOI: https://doi.org/10.4143/crt.2018.221
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Health-related quality of life (HRQOL) information related to radical prostatectomy (RP) is valuable for prostate cancer (PC) patients needing to make treatment decisions. We aimed to investigate HRQOL change in PC patients who underwent three types of RP (open, laparoscopic, or robotic) and compared their HRQOL with that of general population.
Materials and Methods
Patients were prospectively recruited between October 2014 and December 2015. European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) and PC-specific module (PR25) were administered before surgery (baseline) and at postoperative 3 and 12 months. At each time point, HRQOL was compared, and a difference of 10 out of 0-100 scale was considered clinically significant.
Results
Among 258 screened patients, 209 (41 open, 63 laparoscopic, and 105 robotic surgeries) were included. Compared to baseline, physical, emotional, and cognitive functioning improved at 12 months. Role functioning worsened at 3 months, but recovered to baseline at 12 months. Pain, insomnia, diarrhea, and financial difficulties also significantly improved at 12 months. Most PR25 scales excluding bowel symptoms deteriorated at 3 months. Urinary symptoms and incontinence aid recovered at 12 months, whereas sexual activity and sexual function remained poor at 12 months. Clinically meaningful differences in HRQOL were not observed according to RP modalities. Compared to the general population, physical and role functioning were significantly lower at 3 months, but recovered by 12 months. Social functioning did not recover.
Conclusion
Most HRQOL domains showed recovery within 12 months after RP, excluding sexual functioning and social functioning. Our findings may guide patients considering surgical treatment for PC.

Citations

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  • Quality of life after robotic versus conventional minimally invasive cancer surgery: a systematic review and meta-analysis
    Russell Seth Martins, Asad Saulat Fatimi, Omar Mahmud, Muhammad Umar Mahar, Arshia Jahangir, Kinza Jawed, Shalni Golani, Ayra Siddiqui, Syed Roohan Aamir, Ali Ahmad
    Journal of Robotic Surgery.2024;[Epub]     CrossRef
  • The Effect of Discharge Education and Post-Discharge Telephone Counseling on Quality of Life in Patients Undergoing Radical Prostatectomy: A Randomized Controlled Study
    İpek Köse Tosunöz, Sevgi Deniz Doğan, Şeyma Yurtseven, Sevban Arslan
    Cukurova Anestezi ve Cerrahi Bilimler Dergisi.2024; 7(3): 205.     CrossRef
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    Louise Dorner Østergaard, Mads Hvid Poulsen, Malene Eiberg Jensen, Lars Lund, Malene Grubbe Hildebrandt, Birgitte Nørgaard
    International Journal of Urological Nursing.2023; 17(1): 15.     CrossRef
  • Quantitative Analysis of Quality of Life and Exploration of Influencing Factors in Patients Undergoing Radical Prostatectomy
    Feiyang Wang, Jiajun Chen, Weihao Wang, Mengyao Li, Chao Peng, Shouhua Pan, Chuanchuan Zhan, Keyuan Zhao, Yulei Li, Lulu Zhang, Gang Xu, Jing Jin
    Urology.2023; 181: 105.     CrossRef
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    Josée Savard, Hanane Moussa, Jean‐François Pelletier, Pierre Julien, Louis Lacombe, Rabi Tiguert, Yves Caumartin, Thierry Dujardin, Paul Toren, Frédéric Pouliot, Michele Lodde, Yves Fradet, Karine Robitaille, Vincent Fradet
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  • Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study
    Amsalu Degu, Ermias Mergia Terefe, Eliab Seroney Some, Gobezie T Tegegne
    Cancer Management and Research.2022; Volume 14: 1525.     CrossRef
  • A systematic review of supervised comprehensive functional physiotherapy after radical prostatectomy
    B. Steenstrup, M. Cartier, F.X. Nouhaud, G. Kerdelhue, M. Gilliaux
    Progrès en Urologie.2022; 32(7): 525.     CrossRef
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    Kehua Yang, Xu Shao, Xinghui Lv, Feimin Yang, Qunyan Shen, Jing Fang, Wei Chen
    Laparoscopic, Endoscopic and Robotic Surgery.2022; 5(3): 92.     CrossRef
  • A Survey on the Quality of Life of Prostate Cancer Patients in Korean Prostate Cancer Patients Association
    Yun-Sok Ha, Kwang Taek Kim, Wook Nam, Hongzoo Park, Sangjun Yoo, Chan Ho Lee, Ho Seok Chung, Woo Suk Choi, Jiyoun Kim, Jaeeun Shin, Jeong Hyun Kim, Cheol Kwak
    The Korean Journal of Urological Oncology.2022; 20(4): 265.     CrossRef
  • Effects of leuprolide acetate on the quality of life of patients with prostate cancer: A prospective longitudinal cohort study
    Myung Soo Kim, Seung Il Jung, Ho Seok Chung, Eu Chang Hwang, Dongdeuk Kwon
    Prostate International.2021; 9(3): 132.     CrossRef
  • Quality of life assessment using EORTC QLQ questionnaires in the prostate cancer population treated with radical prostatectomy: a systematic review
    Tomasz Jurys, Jacek Durmala
    Scandinavian Journal of Urology.2021; 55(2): 90.     CrossRef
  • Évaluation de l’observance et de l’adhésion thérapeutique de deux protocoles de rééducation après prostatectomie
    Benoit Steenstrup, Claire Breton, Guillaume Galliou, François-Xavier Nouhaud
    Kinésithérapie, la Revue.2021; 21(234): 12.     CrossRef
  • Metabolic syndrome, levels of androgens, and changes of erectile dysfunction and quality of life impairment 1 year after radical prostatectomy
    Yann Neuzillet, Mathieu Rouanne, Jean-François Dreyfus, Jean-Pierre Raynaud, Marc Schneider, Morgan Roupret, Sarah Drouin, Marc Galiano, Xavier Cathelinau, Thierry Lebret, Henry Botto
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  • 10,127 View
  • 294 Download
  • 14 Web of Science
  • 15 Crossref
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Medical Travel among Non-Seoul Residents to Seek Prostate Cancer Treatment in Medical Facilities of Seoul
Jae Heon Kim, So Young Kim, Seok-Joong Yun, Jae Il Chung, Hoon Choi, Ho Song Yu, Yun-Sok Ha, In-Chang Cho, Hyung Joon Kim, Hyun Chul Chung, Jun Sung Koh, Wun-Jae Kim, Jong-Hyock Park, Ji Youl Lee
Cancer Res Treat. 2019;51(1):53-64.   Published online February 20, 2018
DOI: https://doi.org/10.4143/crt.2017.468
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aims to investigate the trend in medical travel by non-Seoul residents to Seoul for treatment of prostate cancer and also to investigate the possible factors affecting the trend.
Materials and Methods
This study represents a retrospective cohort study using data from theKoreanNationalHealth Insurance System from 2002 to 2015. Annual trends were produced for proportions of patients who traveled according to the age group, economic status and types of treatment. Multiple logistic analysiswas used to determine factors affecting surgeries at medical facilities in Seoul among the non-Seoul residents.
Results
A total of 68,543 patients were defined as newly diagnosed prostate cancer cohorts from 2005 to 2014. The proportion of patients who traveled to Seoul for treatment, estimated from cases with prostate cancer-related claims, decreased slightly over 9 years (28.0 at 2005 and 27.0 at 2014, p=0.02). The average proportion of medical travelers seeking radical prostatectomy increased slightly but the increase was not statistically significant (43.1 at 2005 and 45.4 at 2014, p=0.26). Income level and performance ofrobot-assisted radical prostatectomy were significant positive factors for medical travel to medical facilities in Seoul. Combined comorbidity diseases and year undergoing surgery were significant negative factors for medical travel to medical facilities in Seoul.
Conclusion
The general trend of patients travelling from outside Seoul for prostate cancer treatment decreased from 2005 to 2014. However, a large proportion of traveling remained irrespective of direct distance from Seoul.

Citations

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  • Relationship between patient outcomes and patterns of fragmented cancer care in older adults with gastric cancer: A nationwide cohort study in South Korea
    Dong-Woo Choi, Seungju Kim, Sun Jung Kim, Dong Wook Kim, Kwang Sun Ryu, Jae Ho Kim, Yoon-Jung Chang, Kyu-Tae Han
    Journal of Geriatric Oncology.2024; 15(2): 101685.     CrossRef
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    Seong Cheol Kim, Seungbong Han, Ji Hyung Yoon, Sungchan Park, Kyung Hyun Moon, Sang Hyeon Cheon, Gyung-Min Park, Taekmin Kwon
    Investigative and Clinical Urology.2024; 65(2): 124.     CrossRef
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    Jae Ho Jeong, Jinhong Jung, Hee Jeong Kim, Jong Won Lee, Beom-Seok Ko, Byung Ho Son, Kyung Hae Jung, Il Yong Chung
    Annals of Surgical Treatment and Research.2023; 104(2): 71.     CrossRef
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    Hui Ge, Liang Zhang, Xuanxuan Ma, Wen Li, Shuwen Li, Pranshu Sahgal
    European Journal of Cancer Care.2023; 2023: 1.     CrossRef
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  • 229 Download
  • 10 Web of Science
  • 10 Crossref
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Selection Criteria for Active Surveillance of Patients with Prostate Cancer in Korea: A Multicenter Analysis of Pathology after Radical Prostatectomy
Chang Wook Jeong, Sung Kyu Hong, Seok Soo Byun, Seong Soo Jeon, Seong Il Seo, Hyun Moo Lee, Hanjong Ahn, Dong Deuk Kwon, Hong Koo Ha, Tae Gyun Kwon, Jae Seung Chung, Cheol Kwak, Hyung Jin Kim
Cancer Res Treat. 2018;50(1):265-274.   Published online April 14, 2017
DOI: https://doi.org/10.4143/crt.2016.477
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Korean patients with prostate cancer (PC) typically present with a more aggressive disease than patients in Western populations. Consequently, it is unclear if the current criteria for active surveillance (AS) can safely be applied to Korean patients. Therefore, this study was conducted to define appropriate selection criteria for AS for patients with PC in Korea.
Materials and Methods
We conducted a multicenter retrospective study of 2,126 patients with low risk PC who actually underwent radical prostatectomy. The primary outcome was an unfavorable disease, which was defined by non-organ confined disease or an upgrading of the Gleason score to ≥ 7 (4+3). Predictive variables of an unfavorable outcome were identified by multivariate analysis using randomly selected training samples (n=1,623, 76.3%). We compared our selected criteria to various Western criteria for the primary outcome and validated our criteria using the remaining validation sample (n=503, 23.7%).
Results
A non-organ confined disease rate of 14.9% was identified, with an increase in Gleason score ≥ 7 (4+3) of 8.7% and a final unfavorable disease status of 20.8%. The following criteria were selected: Gleason score ≤ 6, clinical stage T1-T2a, prostate-specific antigen (PSA) ≤ 10 ng/mL, PSA density < 0.15 ng/mL/mL, number of positive cores ≤ 2, and maximum cancer involvement in any one core ≤ 20%. These criteria provided the lowest unfavorable disease rate (11.7%) when compared to Western criteria (13.3%-20.7%), and their validity was confirmed using the validation sample (5.9%).
Conclusion
We developed AS criteria which are appropriate for Korean patients with PC. Prospective studies using these criteria are now warranted.

Citations

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    Chang Wook Jeong
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    Sahyun Pak, Kyu-Won Jung, Eun-Hye Park, Young Hwii Ko, Young-Joo Won, Jae Young Joung
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Cancer-Specific Mortality Among Korean Men with Localized or Locally Advanced Prostate Cancer Treated with Radical Prostatectomy Versus Radiotherapy: A Multi-Center Study Using Propensity Scoring and Competing Risk Regression Analyses
Kyo Chul Koo, Jin Seon Cho, Woo Jin Bang, Seung Hwan Lee, Sung Yong Cho, Sun Il Kim, Se Joong Kim, Koon Ho Rha, Sung Joon Hong, Byung Ha Chung
Cancer Res Treat. 2018;50(1):129-137.   Published online March 8, 2017
DOI: https://doi.org/10.4143/crt.2017.004
AbstractAbstract PDFPubReaderePub
Purpose
Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments.
Materials and Methods
The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n=2,521) or RT±ADT (n=507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints.
Results
Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7% and 92.0%, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥ 8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥ 75 years (p=0.002) and CCI ≥ 2 (p < 0.001).
Conclusion
RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities.

Citations

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    International Journal of Urology.2024; 31(11): 1180.     CrossRef
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    Berdine L. Heesterman, Katja K. H. Aben, Igle Jan de Jong, Floris J. Pos, Olga L. van der Hel
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    Jun Seop Kim, Jae Hoon Chung, Wan Song, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Change Jeong, Seong Il Seo, Hyun Moo Lee, Seong Soo Jeon
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Re-stratification of Patients with High-Risk Prostate Cancer According to the NCCN Guidelines among Patients Who Underwent Radical Prostatectomy: An Analysis Based on the K-CaP Registry
Kwang Suk Lee, Kyo Chul Koo, In Young Choi, Ji Youl Lee, Jun Hyuk Hong, Choung-Soo Kim, Hyun Moo Lee, Sung Kyu Hong, Seok-Soo Byun, Koon Ho Rha, Byung Ha Chung
Cancer Res Treat. 2018;50(1):88-94.   Published online March 7, 2017
DOI: https://doi.org/10.4143/crt.2016.494
AbstractAbstract PDFPubReaderePub
Purpose
The present study aimed to re-stratify patients with high-risk prostate cancer according to the National Comprehensive Cancer Network guidelines among patients who underwent radical prostatectomy (RP).
Materials and Methods
This study used the Korean Prostate Cancer Database registry and identified 1,060 patients with high-risk prostate cancer who underwent RP between May 2001 and April 2013. All patients were categorized into risk groups, and subgroups were identified according to the type and number of high-risk factors.
Results
Of the 1,060 high-risk patients, 599 (56.5%), 408 (38.5%), and 53 (5.0%) had 1, 2, and 3 risk factors, respectively. In multivariate analysis, the Gleason score, percentage of positive biopsy cores, and number of risk factors present were identified as independent predictors of biochemical recurrence. There were significant differences in the 5-year postoperative biochemical failure-free survival (BCFFS) rate among the different high-risk factor subgroups (log-rank p < 0.001). There were no significant differences in the BCFFS rate between the subgroup of high-risk patients with a prostate-specific antigen level > 20 ng/mL alone and the intermediate-risk group with all factors (log-rank p=0.919 and p=0.781, respectively). Additionally, no significant differencewas noted in the BCFFS rate between high-risk patients having all factors and those in the very-high-risk group (p=0.566).
Conclusion
We successfully re-stratified patients with high-risk prostate cancer and identified the combinations of high-risk criteria that will help in the selection of patients for RP.

Citations

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    Cheng-Kuang Yang, Chi-Rei Yang, Yen-Chuan Ou, Chen-Li Cheng, Hao-Chung Ho, Kun-Yuan Chiu, Shian-Shiang Wang, Jian-Ri Li, Chuan-Shu Chen, Chi-Feng Hung, Cheng-Che Chen, Shu-Chi Wang, Chia-Yen Lin, Sheng-Chun Hung
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    Christian Ekanger, Svein Inge Helle, Daniel Heinrich, Dag Clement Johannessen, Ása Karlsdóttir, Yngve Nygård, Ole Johan Halvorsen, Lars Reisæter, Rune Kvåle, Liv Bolstad Hysing, Olav Dahl
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Bcl-2 as a Predictive Factor for Biochemical Recurrence after Radical Prostatectomy: An Interim Analysis
In-Chang Cho, Han Soo Chung, Kang Su Cho, Jeong Eun Kim, Jae Young Joung, Ho Kyung Seo, Jinsoo Chung, Weon Seo Park, Eun Kyung Hong, Kang Hyun Lee
Cancer Res Treat. 2010;42(3):157-162.   Published online September 30, 2010
DOI: https://doi.org/10.4143/crt.2010.42.3.157
AbstractAbstract PDFPubReaderePub
Purpose

The objective of this study was to determine Bcl-2 expression in localized prostate cancer and its potential role as a predictive factor for biochemical recurrence (BCR).

Materials and Methods

This study included 171 Korean patients with newly diagnosed adenocarcinoma of the prostate who underwent radical prostatectomy (RP) without neoadjuvant therapy at a single center between February 2005 and May 2009. RP specimens obtained from these patients were analyzed for the expression of Bcl-2 using tissue microarray. The values of Bcl-2 and other clinicopathologic factors were evaluated. Statistical analysis was performed with contingency table analysis, chi-square tests, and a Cox proportional hazard model.

Results

Bcl-2 expression was immunohistologically-confirmed in 42 patients (24.6%). Bcl-2 expression was not associated with conventional clinicopathologic factors. Bcl-2 negative patients had a significantly longer mean BCR-free survival than Bcl-2-positive patients (p=0.036). Among several variables, a high Gleason score in the RP specimen (≥8), extraprostatic extension, seminal vesicle invasion (SVI), lymphovascular invasion (LVI), and Bcl-2 expression were significant predictors of BCR based on univariate analysis. Multivariate Cox proportional hazards analysis revealed that BCR was significantly associated with a high prostate specific antigen level (p=0.047), SVI (p<0.001), a positive surgical margin (p=0.004) and Bcl-2 expression (p=0.012).

Conclusion

Bcl-2 expression in RP specimens is associated with a significantly worse outcome, suggesting a potential clinical role for Bcl-2. Post-operative Bcl-2 could be a significant predictor of outcome after RP.

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    Jakub Karwacki, Marcel Stodolak, Andrzej Dłubak, Łukasz Nowak, Adam Gurwin, Kamil Kowalczyk, Paweł Kiełb, Nazar Holdun, Wojciech Szlasa, Wojciech Krajewski, Agnieszka Hałoń, Anna Karwacka, Tomasz Szydełko, Bartosz Małkiewicz
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    R.F. Velázquez-Macías, F.E. De La Torre-Rendón, G. Ramos-Rodríguez, C.A. Calzada-Mendoza, R.M. Coral-Vázquez
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    AKIRA KOMIYA, TOMONORI KATO, TAKASHI HORI, JUNYA FUKUOKA, KENJI YASUDA, HIDEKI FUSE
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    BERLINDA VERDOODT, MATTHIAS NEID, MARKUS VOGT, VIKTORIA KUHN, SVEN-THORSTEN LIFFERS, REIN-JÜRI PALISAAR, JOACHIM NOLDUS, ANDREA TANNAPFEL, ALIREZA MIRMOHAMMADSADEGH
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Review Article
Salvage Radiotherapy for Patients with PSA Relapse Following Radical Prostatectomy: Issues and Challenges
Richard Choo
Cancer Res Treat. 2010;42(1):1-11.   Published online March 31, 2010
DOI: https://doi.org/10.4143/crt.2010.42.1.1
AbstractAbstract PDFPubReaderePub

A progressively rising level of serum prostate specific antigen (PSA) after radical prostatectomy (RP) invariably indicates the recurrence of prostate cancer. The optimal management of patients with post-RP PSA relapse has remained uncertain due to a wide variability in the natural course of post-RP PSA relapse and the inability to separate a recurrent disease confined to the prostate bed from that with occult distant metastasis. Management uncertainty is further compounded by the lack of phase III clinical studies demonstrating which therapeutic approach, if any, would prolong life with no significant morbidity. Radiotherapy has been the main therapeutic modality with a curative potential for patients with post-RP PSA relapse. This review article depicts issues and challenges in the management of patients with post-RP PSA relapse, presents the literature data for the efficacy of salvage radiotherapy, either alone or in combination of androgen ablation therapy, and discusses future directions that can optimize treatment strategies.

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Original Article
Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy
Hoon Choi, Young Hwii Ko, Sung Gu Kang, Seok Ho Kang, Hong Seok Park, Jun Cheon, Vipul R. Patel
Cancer Res Treat. 2009;41(4):205-210.   Published online December 31, 2009
DOI: https://doi.org/10.4143/crt.2009.41.4.205
AbstractAbstract PDFPubReaderePub
Purpose

To determine whether the biopsy core number and time interval between prostate biopsy and radical prostatectomy affect the operative and oncologic outcome of robot assisted laparoscopic radical prostatectomy (RALP).

Materials and Methods

From January 2008 to April 2009, a single surgeon performed 72 RALPs after an initial learning period of 30 cases. The relationship between time from biopsy to prostatectomy and biopsy core number with operative time and estimated blood loss (EBL) were initially evaluated with a linear regression model. These patients were classified into groups according to whether the interval from biopsy to RALP was within four weeks or not, and whether there were less than or greater than 10 core specimens removed.

Results

RALP was performed in 34 patients within four weeks of biopsy, and in 38 patients more than 4 weeks after biopsy. According to the number of core specimens removed, less than 10 cores were performed in 10 patients, and more than 10 cores were performed in 62 patients. Using an interval of 4 weeks as the cutoff point, early surgery was associated with longer operating time (232.6 vs 208.8 min) and increased estimated blood loss (305.1 vs 276.9 mL). For cases with more than 10 biopsy cores, there was a slight increase in operative time (229.2 vs 210.3 min). None of these differences were statistically significant by multivariate analysis.

Conclusion

Our data suggests that there is no reason to delay RALP to more than 4 weeks after prostate biopsy. It also revealed that the number of biopsy cores (up to 14) did not influence operative outcome. Thus, RALP is a feasible procedure regardless of the biopsy related prostate state.

Citations

Citations to this article as recorded by  
  • Effect of Transperineal Versus Transrectal Prostate Biopsy on the Quality of Hydrogel Spacer Placement in Men Prior to Radiation Therapy for Prostate Cancer
    Michael E. Rezaee, Ulysses Gardner, Mark N. Alshak, Stephen C. Greco, Daniel Y. Song, Michael Goldstein, Christian P. Pavlovich
    Urology.2023; 182: 27.     CrossRef
  • Does time interval between prostate biopsy and surgery affect outcomes of radical prostatectomy? A systematic review and meta-analysis
    Jie Li, Qing Jiang, Qiubo Li, Yuanfeng Zhang, Liang Gao
    International Urology and Nephrology.2020; 52(4): 619.     CrossRef
  • Short interval of biopsy to robotic-assisted laparoscopic radical prostatectomy does not render any adverse effects on the perioperative outcomes
    Minke He, Yaohui Li, Zhuoyi Xiang, Li-an Sun, Yanjun Zhu, Xiaoyi Hu, Jianming Guo, Hang Wang
    Medicine.2018; 97(36): e11686.     CrossRef
  • A Multidimensional Analysis of Prostate Surgery Costs in the United States: Robotic-Assisted versus Retropubic Radical Prostatectomy
    Akash Bijlani, April E. Hebert, Mike Davitian, Holly May, Mark Speers, Robert Leung, Nihal E. Mohamed, Henry S. Sacks, Ashutosh Tewari
    Value in Health.2016; 19(4): 391.     CrossRef
  • Interval from Prostate Biopsy to Radical Prostatectomy Does Not Affect Immediate Operative Outcomes for Open or Minimally Invasive Approach
    Bumsoo Park, Seol Ho Choo, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi
    Journal of Korean Medical Science.2014; 29(12): 1688.     CrossRef
  • Interval from Prostate Biopsy to Robot-Assisted Laparoscopic Radical Prostatectomy (RALP): Effects on Surgical Difficulties
    In Sung Kim, Woong Na, Jung Su Nam, Jong Jin Oh, Chang Wook Jeong, Sung Kyu Hong, Seok Soo Byun, Sang Eun Lee
    Korean Journal of Urology.2011; 52(10): 664.     CrossRef
  • Prostate-Specific Antigen Density as a Powerful Predictor of Extracapsular Extension and Positive Surgical Margin in Radical Prostatectomy Patients with Prostate-Specific Antigen Levels of Less than 10 ng/ml
    Jin-Seok Chang, Hoon Choi, Young-Seop Chang, Jin-Bum Kim, Mi Mi Oh, Du Geon Moon, Jae Hyun Bae, Jun Cheon
    Korean Journal of Urology.2011; 52(12): 809.     CrossRef
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