| 저자(한글) |
Mizuno, Kei,Inoue, Takahiro,Miyazaki, Yu,Makino, Yuki,Terada, Naoki,Kobayashi, Takashi,Yamasaki, Toshinari,Matsui, Yoshiyuki,Kamba, Tomomi,Yoshimura, Koji,Mikami, Yoshiki,Ogawa, Osamu |
| 초록 |
Neurovascular bundle (NVB) preservation is a mandatory procedure to maintain erectile function of localized prostate cancer patients after radical prostatectomy (RP). However, in terms of cancer control, indications to select appropriate patients for nerve-sparing RP are still controversial. In this study, we examined the pathological findings of RP specimens to develop a preoperative criterion for NVB preservation during RP. The study included 76 patients who underwent RP at our institution from 2006 to 2008, and we retrospectively analyzed RP specimens pathologically. The distance between NVB and foci of prostate cancer was measured in 135 prostate sides, and preoperative factors which predict the distance of 2 mm was evaluated. Univariate analysis showed that side-specific positive biopsy core rate 33.3%, side-specific maximum tumor length in biopsy core 5 mm and side-specific tumor involvement rate in biopsy core 50% was associated with the risk of the distance of 2 mm. Multivariate analysis revealed that side-specific positive biopsy core rate 33.3% was the only significant predictor of the ipsilateral NVB-tumor distance 2 mm (p = 0.0055, odds ratio 3.49). Based on this study, a nerve-sparing criterion of 33.3% side-specific percent positive biopsy core was developed at our institution. Prospective data on patients who were applied this criterion are needed to evaluate its clinical safety and feasibility. |
