Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study

Only 54% of prostate cancer cases in Korea are localized compared with 82% of cases in the US. Furthermore, half of Korean patients are upgraded after radical prostatectomy (41.6%–50.6%). We investigated the risk factors for upgrading and/or upstaging of low-risk prostate cancer after radical prosta...

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Main Authors:	Hwang, Insang, Lim, Donghoon, Jeong, Young Beom, Park, Seung Chol, Noh, Jun Hwa, Kwon, Dong Deuk, Kang, Taek Won
Format:	Online
Language:	English
Published:	Medknow Publications & Media Pvt Ltd 2015
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577596/

id	pubmed-4577596
recordtype	oai_dc
spelling	pubmed-45775962015-09-23 Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study Hwang, Insang Lim, Donghoon Jeong, Young Beom Park, Seung Chol Noh, Jun Hwa Kwon, Dong Deuk Kang, Taek Won Original Article Only 54% of prostate cancer cases in Korea are localized compared with 82% of cases in the US. Furthermore, half of Korean patients are upgraded after radical prostatectomy (41.6%–50.6%). We investigated the risk factors for upgrading and/or upstaging of low-risk prostate cancer after radical prostatectomy. We retrospectively reviewed the medical records of 1159 patients who underwent radical prostatectomy at five hospitals in Honam Province. Preoperative data on standard clinicopathological parameters were collected. The radical prostatectomy specimens were graded and staged and we defined a “worsening prognosis” as a Gleason score ≥ 7 or upstaging to ≥ pT3. Multivariate logistic regression models were used to assess factors associated with postoperative pathological upstaging. Among the 1159 patients, 324 were classified into the clinically low-risk group, and 154 (47.5%) patients were either upgraded or upstaged. The multivariable analysis revealed that the preoperative serum prostate-specific antigen level (odds ratio [OR], 1.131; 95% confidence interval [CI], 1.007–1.271; P= 0.037), percent positive biopsy core (OR: 1.018; 95% CI: 1.002–1.035; P= 0.032), and small prostate volume (≤30 ml) (OR: 2.280; 95% CI: 1.351–3.848; P= 0.002) were predictive of a worsening prognosis. Overall, 47.5% of patients with low-risk disease were upstaged postoperatively. The current risk stratification criteria may be too relaxed for our study cohort. Medknow Publications & Media Pvt Ltd 2015 2014-12-30 /pmc/articles/PMC4577596/ /pubmed/25578934 http://dx.doi.org/10.4103/1008-682X.143751 Text en Copyright: © Asian Journal of Andrology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Hwang, Insang Lim, Donghoon Jeong, Young Beom Park, Seung Chol Noh, Jun Hwa Kwon, Dong Deuk Kang, Taek Won
spellingShingle	Hwang, Insang Lim, Donghoon Jeong, Young Beom Park, Seung Chol Noh, Jun Hwa Kwon, Dong Deuk Kang, Taek Won Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study
author_facet	Hwang, Insang Lim, Donghoon Jeong, Young Beom Park, Seung Chol Noh, Jun Hwa Kwon, Dong Deuk Kang, Taek Won
author_sort	Hwang, Insang
title	Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study
title_short	Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study
title_full	Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study
title_fullStr	Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study
title_full_unstemmed	Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study
title_sort	upgrading and upstaging of low-risk prostate cancer among korean patients: a multicenter study
description	Only 54% of prostate cancer cases in Korea are localized compared with 82% of cases in the US. Furthermore, half of Korean patients are upgraded after radical prostatectomy (41.6%–50.6%). We investigated the risk factors for upgrading and/or upstaging of low-risk prostate cancer after radical prostatectomy. We retrospectively reviewed the medical records of 1159 patients who underwent radical prostatectomy at five hospitals in Honam Province. Preoperative data on standard clinicopathological parameters were collected. The radical prostatectomy specimens were graded and staged and we defined a “worsening prognosis” as a Gleason score ≥ 7 or upstaging to ≥ pT3. Multivariate logistic regression models were used to assess factors associated with postoperative pathological upstaging. Among the 1159 patients, 324 were classified into the clinically low-risk group, and 154 (47.5%) patients were either upgraded or upstaged. The multivariable analysis revealed that the preoperative serum prostate-specific antigen level (odds ratio [OR], 1.131; 95% confidence interval [CI], 1.007–1.271; P= 0.037), percent positive biopsy core (OR: 1.018; 95% CI: 1.002–1.035; P= 0.032), and small prostate volume (≤30 ml) (OR: 2.280; 95% CI: 1.351–3.848; P= 0.002) were predictive of a worsening prognosis. Overall, 47.5% of patients with low-risk disease were upstaged postoperatively. The current risk stratification criteria may be too relaxed for our study cohort.
publisher	Medknow Publications & Media Pvt Ltd
publishDate	2015
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577596/
_version_	1613477900447645696

Upgrading and upstaging of low-risk prostate cancer among Korean patients: a multicenter study

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