한국 전립샘암 데이터베이스를 활용한 근치적 전립샘절제술 후 생화학적 재발 예측
Biochemical Recurrence Prediction after Radical Prostatectomy Using Korean Prostate Cancer Registry Database
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Objectives: As the surgical techniques are developed such as adopting robotic surgery etc. It has been reduced postoperative side effects such as urinary incontinence and sexual dysfunction etc., but also remain constant risk of recurrence after the treatment. It is very important to figure out the predictive factors, whichincreasing the probability of long-term survival, by Analyzing the progression of the disease according to biochemical recurrence (BCR). This study aims to figure out the influential predictive factors on BCR by using Korean Prostate Cancer Registry (KPCR) database, which constructedwith providing data from Korean manifold, because of therecurrence-free survival rates are reported to vary according to geographical location and race. Methods: KPCR database consists 7,394 patients’ data which collected from six medical institutions, and final analysis was conducted with 5,119 patients’ data which collected from December 2003 to December 2014. Statistical analysis was conducted with the multivariable Cox proportional hazard regression models to figure out the correlation of clinical factors which affect BCR. The biochemical recurrence free survival rate (BCR-FS) was calculated using with Kaplan-Meier method. Results: The 5 year BCR occurred in 23.6% (1,209 patients). As a result of the recurrence rate, prostate specific antigen (PSA) value ≥20.1 ng/mL was 49.3%, the clinical T3 stage was 40.4%, Gleason score ≥8 was 54.4%, Gleason score 7 was 21.8%. The mean duration of BCR was 20.7 months and the strongest predictor of BCR was Gleason scoreand PSA value ≥20.1 ng/mL. Conclusions: It has been verified that, Gleason scores and PSA value are the most influential factors for biochemical recurrence after radical prostatectomy. These results will be helpful fordetermining the treatment direction in postoperative follow-up and able to contribute to improving survival outcome in the future.
Abstract
Objectives: As the surgical techniques are developed such as adopting robotic surgery etc. It has been reduced postoperative side effects such as urinary incontinence and sexual dysfunction etc., but also remain constant risk of recurrence after the treatment. It is very important to figure out the predictive factors, whichincreasing the probability of long-term survival, by Analyzing the progression of the disease according to biochemical recurrence (BCR). This study aims to figure out the influential predictive factors on BCR by using Korean Prostate Cancer Registry (KPCR) database, which constructedwith providing data from Korean manifold, because of therecurrence-free survival rates are reported to vary according to geographical location and race. Methods: KPCR database consists 7,394 patients’ data which collected from six medical institutions, and final analysis was conducted with 5,119 patients’ data which collected from December 2003 to December 2014. Statistical analysis was conducted with the multivariable Cox proportional hazard regression models to figure out the correlation of clinical factors which affect BCR. The biochemical recurrence free survival rate (BCR-FS) was calculated using with Kaplan-Meier method. Results: The 5 year BCR occurred in 23.6% (1,209 patients). As a result of the recurrence rate, prostate specific antigen (PSA) value ≥20.1 ng/mL was 49.3%, the clinical T3 stage was 40.4%, Gleason score ≥8 was 54.4%, Gleason score 7 was 21.8%. The mean duration of BCR was 20.7 months and the strongest predictor of BCR was Gleason scoreand PSA value ≥20.1 ng/mL. Conclusions: It has been verified that, Gleason scores and PSA value are the most influential factors for biochemical recurrence after radical prostatectomy. These results will be helpful fordetermining the treatment direction in postoperative follow-up and able to contribute to improving survival outcome in the future.
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