Application of the Epstein criteria for prediction of clinically insignificant prostate cancer in Korean men

作者：Lee Sang E; Kim Dae S; Lee Won K; Park Hong Z; Lee Chang J; Doo Seung H; Jeong Seong J; Yoon Cheol Y; Byun Seok Soo; Choe Gheeyoung; Hwang Sung I; Lee Hak J; Hong Sung K^*

来源：BJU International, 2010, 105(11): 1526-1530.

DOI：10.1111/j.1464-410X.2009.09070.x

• insignificant prostate cancer
• Epstein criteria
• Korea

OBJECTIVE
To investigate the rate of pathologically confirmed unfavourable prostate cancers among Korean men who fulfilled the contemporary Epstein criteria for clinically insignificant prostate cancer.
PATIENTS AND METHODS
This was a retrospective study of 131 Korean men who underwent radical prostatectomy (RP) for clinically insignificant prostate cancer as defined by contemporary Epstein criteria. We assessed the percentage of unfavourable prostate cancer (pathological Gleason sum >= 7 and/or extraprostatic extension [EPE]) among these men and tried to identify useful predictors for such unfavourable tumour profiles using uni- and multivariate analyses.
RESULTS
Among 131 men with clinically insignificant prostate cancer, 40 (30.5%) had pathological Gleason >= 7 tumours after RP. Of these 40 men, four (3.1%) also had EPE on examination of RP specimen. All those who did not have Gleason score upgrading after RP had organ-confined disease from examination of RP specimen. Overall, 40 (30.5%) of the 131 men who fulfilled the contemporary Epstein criteria for clinically insignificant prostate cancer before RP had pathologically unfavourable disease. Among our patients, no significant preoperative predictor of pathologically unfavourable disease was identified using uni- and multivariate analyses.
CONCLUSION
Our results showed that a significant proportion of contemporary Korean patients who meet all the conditions of the contemporary Epstein criteria for prediction of clinically insignificant prostate cancer might actually harbour prostate cancer with unfavourable pathological features. Such findings should be considered when treatment options are contemplated based upon the Epstein criteria among Asian patients.

• 出版日期2010-6