Cancer - Prostate(구연) (E-114)

낮은 위험도를 가진 전립선암 환자군들에 있어서 grade group 1, 2의 생존율 비교
분당서울대학교병원
이민승, 김학주, 송상헌, 김정권, 이학민, 이상철, 변석수, 이상은, 홍성규
Objectives
To investigate the comparison of Grade group 1 (GG1) and Grade group 2 (GG2) on survival outcomes in low risk patients with prostate cancer who underwent radical prostatectomy (RP).
Methods
From November 2003 to December 2019, 1983 GG1 and GG2 prostate cancer patients who underwent RP at a single institution were enrolled in the study. All patients were divided into two groups according to biopsy results at diagnosis and peri-operative parameters and recurrence outcomes were compared. Multivariate Cox proportional hazard analysis was performed to identify the significance of biopsy results regarding prostate cancer progression.
Results
Among a total 1983 prostate cancer patients who have low risk (PSA <10, Clinical T stage ≤T2a), 1188 patients had GG1 and 795 patients had GG2 prostate cancer. GG1 patients had a lower rate of positive surgical margin, seminal vesicle invasion than GG2 patients (14.4% vs 19.2%, 0.8% vs 2.6%, P<0.005), and the rate of upgrading Pathologic results was higher (75.8% vs 30.9%, P<0.005). During median follow-up of 63 months, biochemical recurrence-free survival rates were 95.0% in GG1 and 91.6% in GG2 (p<0.005), and overall survival 97.1% in GG1 group and 97.7% in GG2 (p=0.451). Multivariate analysis showed that positive core number (hazard ratio [HR] 1.085, p=0.035), Pathological Gleason score (HR 1.747, p <0.005), Positive surgical margin (HR 2.805, p <0.005), Seminal vesicle invasion (HR 4.191, p <0.005), were significant predictors of biochemical recurrence.
Conclusions
Among prostate cancer patients who underwent RP, patients with GG2 showed worse prognosis regarding biochemical recurrence. Considering this difference in recurrence, active surveillance in GG2 still seems to require further research.
keywords : survival, grade group, prostate cancer

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