다기관 한국 전립샘 암 등록(KPCR) 데이터베이스를 이용한 근치적 전립샘 절제술의 수술 결과 비교

Abstract

Objectives: Prostate cancer, commonly is rapidly increasing the incidence of prostate cancer among Korean men. Primary treatment of localized prostate cancer involves radical prostatectomy, and surgery techniques are divided into the abdominal, laparoscopic, and robotic surgery. Different surgical techniques differ in quality of life, economic aspect, and outcome of surgery and prognosis. Therefore we compared the outcomes and prognosis of patients who underwent surgery for localized prostate cancer using the multicenter Korean Prostate Cancer Registry (KPCR) database. Methods: The KPCR database collected data of 6,032 patients from five medical institutions, and data standardization and quality management were performed to ensure data integrity. We extracted data necessary for analysis from the KPCR database. We analyzed data for 3,262 patients during the period from January 2006 to December 2011. The demographic characteristics, surgical outcomes, and prognosis of patients with localized prostate cancer were analyzed. All statistical analyses were performed using one-way ANOVA, chi-square test, and post-hoc analysis. We used the Kaplan-Meier method and multivariable Cox proportional hazard regression model for biochemical recurrence-free survival rate (BCR-FS) analysis. Results: The analysis results showed that the average initial prostate specific antigen value was 10.30 ng/mL. A total of 56.7% of the patients had clinical stage T2, 43.3% had stage T1, and 64.4% of the patients had a Gleason score of more than 7. The rate of positive surgical margin was radical retropubic prostatectomy, laparoscopic radical prostatectomy, robotic-assisted laparoscopic radical prostatectomy (RALP) as 33.6%, 27% and 28.8%, respectively (p<0.001). The RALP gave excellent results for postoperative complication, and estimated blood loss (EBL). The 5-year overall BCR-FS was 77.0%, and the three surgical techniques did not differ in clinical outcomes. Cox regression analysis showed that the surgical technique did not affect the biochemical recurrence rate. Conclusions: Our study describes the characteristics of patients with localized prostate cancer and their prognosis. These results indicate that patients and medical staff can rely on information from the KPCR database for decision-making.