Cancer - Prostate(구연) International Session I (I-11) Rm. 202 10월 31일(목) 15:00-16:00 Outcomes of pathologically localized high-grade prostate cancer after radical prostatectomy in adjuvant treatment-naïve patients: a re-evaluation 2019 연세대학교 의과대학 비뇨의학과교실 허지은, 박지수, 이종수, 김종찬, 장원식, 나군호, 최영득, 홍성준, 함원식 Purpose: Traditionally, 60% of men with high-grade (Gleason score [GS] 8 to 10) and organ confined prostate cancer (PC) have biochemical recurrence (BCR) at 5 years after radical prostatectomy (RP), but these are not candidate for adjuvant radiation therapy (ART) in current guidelines. We evaluated BCR risk in a current single-center cohort of men with pathologically localized high-grade PC. Methods: Of 4,969 men who underwent RP at our institution between 1995 and 2015, 210 with pathological GS 8 to 10 and pT2 were included in analysis. We compared BCR risk of these men (group 3) with those of group 1 (pGS7(3+4) and pT3; n=654), group 2 (pGS7(4+3) and pT3; n= 408), which are current candidate for ART. Results: At a median follow-up of 61 months (interquartile range: 39–87), 432 men experienced BCR. BCR-free survival (BCRFS) rates were lower in group 3 than group 1 and 2 (p<0.001 and p=0.021, respectively). This association persisted in multivariate Cox regression analysis. There was no difference in BCRFS between group 2 and 3 with positive surgical margin (SM) (p=0.101). Group 3 with negative SM showed lower BCRFS than group 1 with positive SM (p=0.038), but no difference was observed compared to that of group 2 with positive SM (p=0.297). Conclusion: In pathologically localized high-grade PC, men with positive SM should be considered for ART. Men with negative SM showed lower or similar BCRFS rates compared to locally advanced GS7 PC with positive SM. Thus, these could be considered for early salvage treatment. keywords : Biochemical recurrence, Gleason score, Surgical margin