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Purpose: Tumor volume has been thought to be an important predictive factor for significant prostate cancer. We assessed the impact of the tumor volume (TV) and the tumor percentage (TP) of radical prostatectomy specimens on the pathological variables and the oncological outcome. Materials and Methods: The tumor percentage and tumor volume were calculated for 525 cases by a single pathologist who determined the volume based on the surface area of the slides involved by tumor of the prostate. Univariate and multivariate logistic regression analyses were used to characterize the association of TP categories (＜5%, 5-10%, 11-20% and ＞20%) and TV (＜1.8cc, 1.8-3.7cc, 3.8-7.5cc, ＞7.5cc) with the clinicopathological variables. Biochemical recurrence (BCR) was estimated using Kaplan-Meier analysis and Cox’s hazard regression model. Results: The mean prostate cancer volume was 6.5±8.5cc (median: 3.8, range: 0.04-73.8) and the mean percent tumor composition was 0.17±0.19

Purpose: To investigate clinicopathologic characteristics of unilateral, low risk prostate cancers detected via multi (≥12)-core prostate biopsy. Materials and Methods: One hundred four patients who underwent radical retropubic prostatectomy (RRP) for unilateral, low risk prostate cancer (clinical stage ≤T2a, biopsy Gleason sum ≤6, PSA ≤10ng/ml, and ipsilateral positive cores ≤2) detected via multi (≥12)-core prostate biopsy were enrolled. In this retrospective study, we reviewed the patients’ preoperative and pathologic data to assess potential predictors of pT2c or greater disease at the time of RRP, as well as characteristics of such disease. Results: Of the 104 subjects, only 34 (32.7%) were pathologically-proven to have unilateral disease, while the others showed pathologically-bilateral or worse disease from analysis of the RRP specimens. Subjects pathologically found to have uniand bi-lateral disease showed no significant differences regarding age, prostate-specific antigen (PSA), free-to-total PSA ratio, prostate volume, clinical stage, number of positive cores, biopsy Gleason score, number of total biopsy sites, and highest percentage of tumor at any biopsy site. Multivariate logistic regression analysis revealed no significant preoperative predictors of pT2c or greater disease at RRP. Conclusions: Most patients with unilateral, low risk prostate cancer detected on multi (≥12)-core prostate biopsy actually had pathologicallyworse disease. For clinically-localized prostate cancer, a more accurate method to identify appropriate candidates for unilateral or focal ablative therapy should be developed. (Korean J Urol 2008;49:874-878) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Data was collected from 525 patients who un-derwent radical prostatectomy for clinically localized prostate cancer from 2003 to 2007. We evaluated the potential associations of multifocality with various clinical and pathologic factors. The ability to predict extra-capsular extension (ECE) was tested by logistic regression models, whereas bioche-mical recurrence (BCR) was assessed via Kaplan-Meier analyses and Cox-hazard regression models. The BCR was defined as a level of serum prostate-specific antigen (PSA) of 0.2ng/ml or greater on consecutive evaluations.

Results: In total, 84 (67.7%) and 40 (32.3%) of patients had final GS of 3+4 and 4+3, respectively. A final GS of 4+3 was associated with a higher pre-biopsy level of prostate-specific antigen (p

Purpose: We retrospectively reviewed the clinicopathological characteristics ofpatients who underwent radical retropubic prostatectomy (RRP), and these patients had clinically localized prostate cancer and a preoperative serum prostate-specific antigen (PSA) level ≥20ng/ml. Materials and Methods: Among the 266 patients who underwent RRP without any prior neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a preoperative serum PSA level ≥20ng/ml. We analyzed several clinicopathologic factors that might predict organ-confined disease. Results: Of the 29 patients, 11 (37.9%) had organ-confined cancer. The level of serum PSA, the PSA density (PSAD), the Gleason score (3+4 or less), the prostate volume, tumor volume and the tumor percentage were significant factors for predicting organ-confined cancer (p

Purpose: Metabolic syndrome, a concurrence of disturbed glucose and insulin metabolism, overweight, abdominal fat distribution, dyslipidemia, and hypertension, has been reported to have some association with prostate cancer. Here, we assessed the relationship between metabolic syndrome and prostate cancer. Materials and Methods: We assessed a total of 261 men who underwent radical retropubic prostatectomy between January 2004 and May 2005. The patients were stratified into two groups, with metabolic syndrome (n=75) or without (n=186). Metabolic syndrome was defined by the criteria of National Cholesterol Education Program Adult Treatment Panel III. We compared the clinical and pathologic features of specimens between the groups. Results: There was no significant difference between the two groups in terms of mean age, serum prostate specific antigen level, prostate size, Gleason score, and pathologic stage. The tumor volume of prostate cancer was significantly higher in the metabolic syndrome group (6.6±5.5cc vs 5.0±4.5cc, p=0.010). No significant differences were observed in extracapsular extension, seminal vesicle invasion, bladder neck invasion, angiolymphatic invasion, perineural invasion, and multicentricity of cancer between the two groups. As the component of metabolic syndrome increased, the tumor volume was also found to increase (p-value=0.025). Conclusions: The data from our study support that metabolic syndrome is closely associated with the development and progression of prostate cancer. (Korean J Urol 2007;48:585-591) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Purpose: We retrospectively reviewed clinicopathological characteristics in patients who underwent radical retropubic prostatectomy (RRP) with clinically localized prostate cancer and a biopsy Gleason score of 8 or higher. Materials and Methods: Among 266 patients who underwent RRP without prior any neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a biopsy Gleason score of 8 or higher. We analyzed several clinicopathologic factors that predict organ-confined disease, and also investigated the impact on postoperative changes of the biopsy Gleason score. Results: Of 29 patients, 12 (41.4%) had organ-confined cancer. Serum prostate-specific antigen (PSA), prostate-specific antigen density (PSAD), tumor volume, and tumor percentage were significant factors for predicting organ-confined cancer (p

Purpose: Since its introduction into clinical practice, a laparoscopic radical prostatectomy (LRP) has been performed at a growing number of centers. LRP can be performed by either a transperitoneal or extraperitoneal approach. The perioperative morbidities were evaluated in two groups of patients; retropubic radical prostatectomy (RRP) or extraperitoneal laparoscopic radical prostatectomy (ELRP). Materials and Methods: Between December 2003 and March 2006, 45 patients were treated with a RRP, and between September 2005 and May 2006, 30 patients underwent an ELRP. The same surgeon performed both types of operation. The perioperative data, including operative time, transfusion rates, hospitalization length and duration of catheterization were analyzed. The pathological parameters, including Gleason score, pathological stage and positive surgical margin rates were also analyzed. Results: There were no significant differences in the preoperative characteristics between the two groups, with the exception of the mean age. The average operative time was significantly shorter in the RRP group (p 0.05). After gaining experience of 15 cases, the ELRP group showed significantly shorter catheterization time (p< 0.005) and hospital stay (p=0.098). The pathological parameters of the two groups were comparable. RRP group were more likely to larger amount of postoperative analgesia (p=0.072). Conclusions: The ELRP procedure showed comparable perioperative results to those of a RRP, with the exception of operative time. After our initial experience, the ELRP showed favorable outcomes with regard to catheterization time and hospital stay. Considering our results, ELRP can be recommended as one of the primary options for managing localized prostate cancer. (Korean J Urol 2007;48:131-137)