Cancer - Prostate(구연) Oral Session 1 / Cancer - Prostate (Ⅰ) (O-009) Grand Ballroom(2F) 11월28일(수) 13:00-14:00 병리학적 T3b 전립선 암에서 근치적 전립선 절제술 후 추적 관찰 중 검출 되지 않는 전립선 특이 항원 유무에 따른 종양학적 예후 연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소 정두용, 고동훈, 고혁준, 김민석, 이종수, 오경택, 장원식, 이주용, 이무상, 최영득 Purpose : Seminal vesicle invasion (pT3b) is associated with adverse clinical outcomes in prostate cancer (PCa) patients. We investigated the prognostic significance according to undetectable prostate specific antigen (PSA) after radical prostatectomy (RP) in pT3b PCa without lymph-node and distant metastasis. Materials and Methods : We retrospectively reviewed clinical data from 366 patients with pT3bN0M0 who underwent RP at our institution between years 1998 and 2015. Patients without adequate medical records were excluded. Kaplan-Meier analyses were performed to analyze biochemical recurrence-free survival (BCRFS) and distant metastasis free survival (DSFS). Univariate and multivariate Cox regression models were used for each endpoint. RESULTS: In a total of 366 patients, there were 168 cases in undetectable PSA and 198 cases in detectable PSA after RP. Mean follow up period after RP was 63.15 (39.50) months. Preoperative factors such as age, BMI, PSA, biopsy Gleason score (GS) were not significantly statistically between two groups. However, adverse pathologic features such as extracapsular extension, postive surgical margin and lymphovascular invasion were statistically different between groups. In the univariate and multivariate Cox regression analyses, Undetectable PSA after RP was a significant predictor of BCR (hazard ratio 3.529, p <0.001) and distant metastasis (hazard ratio 1.819, p = 0.032). Kaplan-Meier curves showed that undetectable PSA after RP was significantly associated with BCRFS (p < 0.001) and DSFS (p = 0.034). CONCLUSIONS: Our results demonstrate that undetectable PSA after RP in pT3b correlates with BCR and distant metastasis. These findings suggest that Patients with pT3b without undetectable PSA after RP may require more aggressive observation of disease progression. keywords : Prostate cancer, Seminal vesicle, Prostate specific antigen