The Pathological Characteristics of Localized Prostate Cancer, Managed with Radical Prostatectomy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Prostate cancer is known as the most common cancer in western men, and their incidences are increasing in oriental men, including Koreans. We made an effort to evaluate the pathological characteristics of this cancer in Koreans. MATERIALS AND METHODS: The medical records of 170 patients with prostate cancer, having undergone a radical retropubic prostatectomy between April 1990 and May 2001 were reviewed. The distributions of preoperative serum PSA levels, preoperative biopsy Gleason scores and clinical stages were evaluated. We analyzed pathological findings, such as the rates of organ confinement, extracapsular extension, seminal vesicle invasion and lymph node involvement. In cases with seminal vesicle invasion, tumor mapping, through microscopic examination of histological sections at multiple levels, were performed to determine the route of invasion. RESULTS: When the patients were stratified according to each preoperative parameter, the largest proportion were found to be in the T1c and T2a clinical stages (40.6%), had Gleason scores between 8 and 10 (34.1%) and serum PSA levels in the range of 4-10ng/ml (32.9%). There were 30.6% of patients with preoperative serum PSA levels greater than 20ng/ml. The rates of organ confinement, extracapsular extension, seminal vesicle invasion and lymph node involvement were 54.7, 17.7, 19.4 and 8.2%, respectively. 75.8% of the seminal vesicle invasions were revealed to be from direct extension of the tumor. CONCLUSIONS: The high incidence of seminal vesicle invasion in Korean prostate cancer patients might be due to the location of the tumors, the aggressiveness of the tumors or racial differences. Considering the reported incidence of seminal vesicle invasion in Japan was 32%, multicentric studies are required to elucidate the cause of the high incidence of seminal vesicle invasion in Asians.