研究者情報

キクチ　エイジ   KIKUCHI EIJI   菊地栄次    所属   医学部医学科 腎泌尿器外科学    職種   主任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	The prognostic value of zonal origin and extraprostatic extension of prostate cancer for biochemical recurrence after radical prostatectomy.
掲載誌名	正式名：Urologic oncology 略　 称：Urol Oncol ISSNコード：1873249610781439
掲載区分	国外
巻・号・頁	37(9),575.e19-575.e25頁
著者・共著者	Takamatsu Kimiharu, Matsumoto Kazuhiro, Shojo Kazunori, Tanaka Nobuyuki, Takeda Toshikazu, Morita Shinya, Kosaka Takeo, Mizuno Ryuichi, Shinojima Toshiaki, Kikuchi Eiji, Asanuma Hiroshi, Oya Mototsugu
発行年月	2019/09
概要	OBJECTIVE:To investigate the influence of the zonal origin of prostate cancer and extraprostatic extension on biochemical recurrence (BCR).PATIENTS AND METHODS:We included 638 consecutive patients undergoing radical prostatectomy between 2005 and 2015 who did not receive neoadjuvant/adjuvant therapy. The largest lesion was defined as the index tumor. We categorized each patient into the transition zone (TZ) or peripheral zone (PZ) group based on the lesion where the index tumor existed. Differences in the BCR defined as increasing prostate-specific antigen rate between groups were examined by Kaplan-Meier analysis and the Cox proportional hazards model.RESULTS:There were 293 (46%) patients with TZ cancer and 345 (54%) with PZ cancer. TZ cancer was significantly associated with a higher prostate-specific antigen (P = 0.012), lower biopsy positive core rate (P =0.020), lower pathological Gleason score (P = 0.017), lower pathological stage (P = 0.002), and lower rate of seminal vesicle invasion (P = 0.002). During a median follow-up period of 59 months, 79 patients (12%) developed BCR. In the entire cohort, the PZ origin (hazard ratio: 1.68, P = 0.033) and extraprostatic extension were independent risk factors for BCR. The 3-, 5-, and 7-year BCR-free survival rates of patients with pT3a TZ cancer were 89%, 88%, and 86%, respectively, which were significantly better than those of patients with pT3a PZ cancer (80%, 74%, and 62%, P = 0.012), but were similar to those of the pT2 cancer cohort (92%, 91%, and 90%, P = 0.376).CONCLUSION:TZ cancer had more favorable pathological characteristics and oncological outcome than PZ cancer especially in pT3a cases.
DOI	10.1016/j.urolonc.2019.03.012
PMID	30967332