The Prostate Cancer Risk Assessment Stratify Predict Pathological Features And PSA Recurrence

Prostate cancer(PCA) is a main threat to male health. the most effective way to a clinical organ-confined prostate cancer is radical prostatectomy. However, different risk CAP have different result for this operation. High risk PCA show a higher recurrent and lower survive. A valid predict to post-operation pathologic features and recurrent after treatments is important to chose a reasonable treatment. The D'Amico's risk assessment stratify is widely accept, and be confirmed in several large researches for predict the post-operation pathological feature and recurrent risk. But this risk assessment stratify is base on west population. There is no report on whether this stratify could fit Chinese.Objection: To verify the PCA risk assessment stratify with Chinese patients. Compare Chinese prostate cancer patients'pathological features and PSA recurrent rate in different risk level with abroad, to evaluate the application of PCA risk assessment stratify in PCA diagnosis.Methods:The study included 146 men who were treated between Sep.2000 and Jun.2006 with radical prostatectomy for clinically localized prostate cancer(mean age 69,serum PSA 1.46 to 100ng/ml,mean PSA 30.9ng/ml,Gleason score <6 86, =7 51,>8 9). According to risk assessment schemes stratify patients into low, intermediate,and high-risk categories.Compare the positive surgical margins rate ,lymph-node invasion rate and seminal-vesicle invasion rate among the 3 categories. The case whose information on post-operative serum PSA were missing or post-operative serum PSA were not descend to 0 were excluded.There were 106 patients remained. Compare the PSA recurrence rate and time among the 3 categories.Result:There are 16 patients in low risk category,47 patients in intermediate risk category and 83 patients in high risk category. The post-operative seminal-vesicle invasion rate in low risk, intermediate risk and high risk category was 0%, 8.5%, and 34.9%. The post-operative seminal-vesicle invasion rate in low risk and intermediate risk categoryies was lower than it in high risk category(p<0.001). The PSA recurrence rate in low risk, intermediate risk and high risk categories was 13.3%, 27.0%, and 57.4%. The PSA recurrence rate in low risk and intermediate risk categoryies was lower than it in high risk category(p<0.05).Conculsion:The post-operative seminal-vesicle invasion rate and PSA recurrence rate in low and intermediate risk categories are lower than them in high risk category.The positive surgical margins rate and lymph node invasion in the 3 risk stratify categories have not significant difference. The PSA recurrence rate are higher than the same research abroad,maybe duo to the higher ratio of high risk category.