Clinical features and prognosis of prostate cancer with high-grade prostatic intraepithelial neoplasia.
OBJECTIVE
To evaluate the clinical features and biochemical recurrence (BCR) in prostate cancer (PCa) with high-grade prostatic intraepithelial neoplasia (HGPIN).


METHODS
We retrospectively analyzed the medical records of 893 patients who underwent a radical prostatectomy for PCa between 2011 and 2012 at Asan Medical Center; 752 of these patients who did not receive neoadjuvant or adjuvant therapy and were followed up for more than 1 year were included. The cohort was divided into two groups-patients with and without HGPIN-and their characteristics were compared. The Cox proportional hazards model was used to analyze factors affecting BCR.


RESULTS
In total, 652 study patients (86.7%) had HGPIN. There were no significant differences in preoperative factors between the two groups, including age (p=0.369) and preoperative prostate-specific antigen concentration (p=0.234). Patients with HGPIN had a higher Gleason score (p=0.012), more frequent multiple tumor (p=0.013), and more perineural invasion (p=0.012), but no other postoperative pathologic characteristics were significantly different between the two groups. There were no significant differences in BCR (13.0% vs. 11.5%, p=0.665) and HGPIN was not associated with BCR (p=0.745). In multivariate analysis, only the T stage (p<0.001) was associated with BCR.


CONCLUSIONS
PCa patients with HGPIN have a higher Gleason score, more frequent multiple tumors, and more perineural invasion than those without HGPIN. The presence of HGPIN is not an independent predictor of BCR.
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Donghyun
D
Lee
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Chunwoo
C
Lee
Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Taekmin
T
Kwon
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Dalsan
D
You
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
In Gab
IG
Jeong
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jun Hyuk
JH
Hong
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hanjong
H
Ahn
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Choung-Soo
CS
Kim
D000368:Aged; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D010525:Peripheral Nerves / Q000473:pathology; D011379:Prognosis; D011468:Prostatectomy; D019048:Prostatic Intraepithelial Neoplasia / Q000473:pathology* / Q000601:surgery; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies
Prostatectomy; Prostatic intraepithelial neoplasia; Prostatic neoplasms