Prostate cancer in Korean men exhibits poor differentiation and is adversely related to prognosis after radical prostatectomy.
OBJECTIVE
To investigate the clinical and pathologic characteristics of prostate cancer in Korean men to determine how ethnic differences affect clinical outcome.


METHODS
The clinical and pathologic data of 604 Korean men who underwent radical prostatectomy from 1994 to 2003 were reviewed. Biochemical failure was defined as a prostate-specific antigen (PSA) level of 0.2 ng/mL or greater on two consecutive occasions after having achieved an undetectable PSA level. Patient distribution with respect to the clinical and pathologic parameters and biochemical failure rates were compared with those of contemporary Western series.


RESULTS
The mean preoperative PSA level was 9.9 ng/mL (range 0.4 to 38.8) and the median biopsy Gleason score was 7. The Gleason score was 7 in 186 patients (30.8%) and greater than 7 in 169 (28.0%). Gleason scores stratified with respect to clinical stage and PSA range revealed the proportion of patients with high Gleason scores (7 or greater) to be more than 50% of each subgroup throughout the clinical stages and PSA ranges. At a median follow-up of 57.9 months (range 22 to 131), biochemical failure occurred in 24.2% of all patients and in 14.3% of those with an initial serum PSA level of 10.0 ng/mL or lower. On multivariate Cox regression analysis, the Gleason score showed the strongest statistical significance for biochemical failure (P = 0.001, hazard ratio 1.376, 95% confidence interval 1.056 to 1.792) for patients with a serum PSA level of 10.0 ng/mL or lower.


CONCLUSIONS
A significant proportion of prostate cancers arising in Korean men exhibit poor differentiation, regardless of the initial serum PSA level or clinical stage at presentation, and adversely affect prognosis, causing a greater rate of PSA failure.
Song
Cheryn
C
Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Ro
Jae Y
JY
Lee
Moo-Song
MS
Hong
Sung-Joon
SJ
Chung
Byung-Ha
BH
Choi
Han Yong
HY
Lee
Sang-Eun
SE
Lee
Eunsik
E
Kim
Choung-Soo
CS
Ahn
Hanjong
H
D000328:Adult; D000368:Aged; D044466:Asian People; D014408:Biomarkers, Tumor / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000208:ethnology* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen