Cancer - Prostate(구연) MP Session Ⅰ (MP-007) Geumkang Hall (Avenue 2F) 11월 28일(수) 16:00-17:00 신경보존술식을 이용한 근치적 전립선절제술의 적용이 가능한 전립선암에서 술 후 upstaging과 upgrading의 예측인자로서 혈중 남성호르몬 수치 경북대학교 의과대학 비뇨기과학교실 변경현, 박경민, 이승윤, 김상원, 정재욱, 하윤석, 최석환, 이준녕, 김범수, 김현태, 김태환, 유은상, 정성광, 권태균 Objectives: Although nerve-sparing radical prostatectomy is currently a widely accepted surgical option, pathological stage and grade after radical prostatectomy were inconsistent with biopsy result in clinically localized prostate cancer. To establish an appropriate surgical technique, it is important to predict pathological result in clinically localized prostate cancer applicable to nerve-sparing radical prostatectomy. In addition, several reports have highlighted that preoperative serum testosterone level is associated with high-stage and high-grade prostate cancer. Therefore, we analyzed factors including preoperative serum testosterone to predict upstaging and upgrading in patients with prostate cancer applicable to nerve-sparing radical prostatectomy. Materials and Methods: We retrospectively evaluated patients who underwent radical prostatectomy from January 2015 to May 2018 in our institution. Patients with Grade group 1 or 2 (Gleason score 6 (3+3) or 7 (3+4)) on biopsy, PSA < 10, and ≤ clinical stage T2 were included in this study. Exclusion criteria included that all patients had previously received 5α-reductase inhibitors, LH-releasing hormone analogues or testosterone replacement treatment, and neo-adjuvant radiotherapy. Upstaging and upgrading were defined as pathological stage ≥ T3a and Grade group ≥ 4 (Gleason score 8 (4+4)) after radical prostatectomy, respectively. We evaluated the patients’ demographics and outcomes after radical prostatectomy according to upstaging and upgrading. Predictive factors for upstaging and upgrading after radical prostatectomy were analyzed using a multivariate logistic regression model. Results: Of 108 patients included in the study, upstage and upgrade after radical prostatectomy were observed in 24 (22.2%) and 36 (33.3%), respectively. Preoperative low serum testosterone level, small prostate size, and positive core number ≥ 4 on biopsy were identified as predictive factors for upstaging in multivariate analysis. Although preoperative low serum testosterone level and Grade group 2 on biopsy were related with upgrading, any factor was not observed in multivariate analysis. Conclusion: In this study, preoperative low serum testosterone level was associated with upstaging and upgrading after radical prostatectomy in clinically localized prostate cancer applicable to nerve-sparing technique. keywords : prostate cancer, testosterone, pathology