Cancer - Prostate(구연) (NP-052) 병리학적 T3a 전립선암 환자에서 생화학적 재발의 위험인자 : 단일 술자 경험 경북대학교병원,¹칠곡경북대학교병원 김상원¹, 오정석, 박경민, 하헌, 정재욱¹, 최석환, 이준녕¹, 김태환¹, 권태균¹ Purpose While the operative management for pathologic T3(pT3) prostate cancer(PCa) is getting popularity with the development of robot-assisted laparoscopic surgery. Oncologic outcomes of patients with pT3a PCa after radical prostatectomy(RP) are heterogeneous. We investigated the risk factors for biochemical recurrence(BCR) in these patients. Methods From January 2011 to June 2016, a total of 110 patients with pT3a PCa after RP performed by single surgeon were retrospectively enrolled. Exclusion criteria were positive pathologic lymph node stage, neoadjuvant hormonal therapy(HT), adjuvant HT or radiation therapy, incomplete data and follow up period is less than 24 months. Clinicopathologic characteristics including age, preoperative PSA, prostate and tumor volume, tumor extent, surgical margin status, and International Society of Urological Pathology(ISUP) grade group were analyzed and onset of BCR was identified. Kaplan–Meier(K-M) survival analysis was used to illustrate BCR-free survival and Cox proportional hazard models were applied to identify factors predicting BCR. Results During the mean follow-up period of 43.6 months(range 3-82 months), BCR was identified in 42(38.2%) patients. In univariate analysis, preoperative PSA, apical margin and ISUP was associated with BCR(P=0.024, 0.005 and 0.003, respectively). In multivariate Cox analysis, these 3 factors were independent prognostic factor for BCR in patients with pT3a PCa (preoperative PSA, hazard ratios(HR)=1.041, confidence interval[CI]=1.015–1.067; apical margin, HR=2.306, CI=1.230-4.326; ISUP 2 vs 4-5, HR=3.948, CI=1.335-11.677). In K-M curve, apical margin and ISUP were statistically significant (Log rank test, P=0.005 and 0.001, respectively). Conclusions In patients with pT3a PCa after RP, preoperative PSA, high ISUP and apical margin status are considered to be the independent risk factors for BCR. Therefore, early adjuvant therapy is mandatory in patients with these risk factors to delay BCR. keywords : Prostate cancer, Risk factor, biochemical recurrence