Cancer - Prostate(구연) (NP-036) 고위험 전립선암 환자에서 골반림프절 절제술의 종양학적 결과: 성향 점수 매치 분석 연세대학교 의과대학 비뇨의학교실, Department of Urology, Tanta University Medical School, Egypt 김종찬, Ahmed Elghiaty¹, 장원식, 허지은, 박지수, 최영득, 함원식 Objectives: To assess the impact of pelvic lymph node dissection (PLND) on survival in the patients with high-risk prostate cancer (HR-PCA). Methods and materials: We reviewed the medical records of 1172 patients who underwent radical prostatectomy due to HR-PCA from March 1995 to December 2014. Patients were divided in 3 groups; no PLND, limited PLND (lPLND) and extended PLND (ePLND). Propensity scores matching analysis were used to balance the selection bias of undergoing PLND with the factor of preoperative PSA, biopsy Gleason score (GS), clinical T stage, pathologic GS, pathologic T stage and positive surgical margin (PSM). We evaluated overall survival (OS), cancer specific survival (CSS) and biochemical recurrence-free survival (BCRFS) between 3 groups by using Kaplan-Meier methods. And we assessed the factors related with OS, CSS and BCRFS using Cox regression models. Results: The ePLND group has higher PSA, biopsy and pathologic GS, clinical and pathologic T stage in the entire cohort. The median follow-up duration was 76 months. In the cohort with propensity score matching, there was no difference in 10-year OS (81.4% vs. 74.1% vs. 81.1%, p=0.625), CSS (88.2% vs. 83.7% vs. 84.3%, p=0.781). Multivariate analysis showed that older age (HR=1.090, p<0.001) was related with poorer OS, and higher pathologic GS (HR=3.238, p=0.005) was related with poorer CSS. Both limited and extended PLND did not affect the OS and CSS. However, ePLND (HR=0.674, p=0.008) was related with better BCRFS with preoperative PSA (HR=1.012, p<0.001), pathologic GS (HR=1.907, p<0.001), pathologic T stage (HR=1.717, p=0.001) and PSM (HR=1.967, p<0.001). Conclusions: PLND seemed to be not associated with OS and CSS in patients with cN0 HR-PCA. However, ePLND was related with higher BCRFS. keywords : High-risk prostate cancer, prostatectomy, pelvic lymph node dissection