Cancer Research and Treatment

Original Articles

Genitourinary Cancer

A Predictive Model Based on Bi-parametric Magnetic Resonance Imaging and Clinical Parameters for Clinically Significant Prostate Cancer in the Korean Population: Tae Il Noh, Chang Wan Hyun, Ha Eun Kang, Hyun Jung Jin, Jong Hyun Tae, Ji Sung Shim, Sung Gu Kang, Deuk Jae Sung, Jun Cheon, Jeong Gu Lee, Seok Ho Kang; Cancer Res Treat. 2021;53(4):1148-1155. Published online December 31, 2020; DOI: https://doi.org/10.4143/crt.2020.1068

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Purpose
This study aimed to develop and validate a predictive model for the assessment of clinically significant prostate cancer (csPCa) in men, prior to prostate biopsies, based on bi-parametric magnetic resonance imaging (bpMRI) and clinical parameters.
Materials and Methods
We retrospectively analyzed 300 men with clinical suspicion of prostate cancer (prostate-specific antigen [PSA] ≥ 4.0 ng/mL and/or abnormal findings in a digital rectal examination), who underwent bpMRI-ultrasound fusion transperineal targeted and systematic biopsies in the same session, at a Korean university hospital. Predictive models, based on Prostate Imaging Reporting and Data Systems scores of bpMRI and clinical parameters, were developed to detect csPCa (intermediate/high grade [Gleason score ≥ 3+4]) and compared by analyzing the areas under the curves and decision curves.
Results
A predictive model defined by the combination of bpMRI and clinical parameters (age, PSA density) showed high discriminatory power (area under the curve, 0.861) and resulted in a significant net benefit on decision curve analysis. Applying a probability threshold of 7.5%, 21.6% of men could avoid unnecessary prostate biopsy, while only 1.0% of significant prostate cancers were missed.
Conclusion
This predictive model provided a reliable and measurable means of risk stratification of csPCa, with high discriminatory power and great net benefit. It could be a useful tool for clinical decision-making prior to prostate biopsies.

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Abbreviated MRI Protocols in the Abdomen and Pelvis
Kristina I. Ringe, Jin Wang, Ying Deng, Shan Pi, Amine Geahchan, Bachir Taouli, Mustafa R. Bashir
Journal of Magnetic Resonance Imaging.2024; 59(1): 58. CrossRef
Magnetic Resonance Imaging, Clinical, and Biopsy Findings in Suspected Prostate Cancer
Arya Haj-Mirzaian, Kristine S. Burk, Ronilda Lacson, Daniel I. Glazer, Sanjay Saini, Adam S. Kibel, Ramin Khorasani
JAMA Network Open.2024; 7(3): e244258. CrossRef
The Barcelona Predictive Model of Clinically Significant Prostate Cancer
Juan Morote, Angel Borque-Fernando, Marina Triquell, Anna Celma, Lucas Regis, Manel Escobar, Richard Mast, Inés M. de Torres, María E. Semidey, José M. Abascal, Carles Sola, Pol Servian, Daniel Salvador, Anna Santamaría, Jacques Planas, Luis M. Esteban, E
Cancers.2022; 14(6): 1589. CrossRef
Efficacy of Tadalafil in Penile Rehabilitation Started Before Nerve-Sparing Robot-Assisted Radical Prostatectomy: A Double-Blind Pilot Study
Tae Il Noh, Ji Sung Shim, Sung Gu Kang, Jun Cheon, Jeong Gu Lee, Seok Ho Kang
Sexual Medicine.2022; 10(3): 1. CrossRef
Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy
Juan Morote, Angel Borque-Fernando, Marina Triquell, Anna Celma, Lucas Regis, Richard Mast, Inés M. de Torres, María E. Semidey, José M. Abascal, Pol Servian, Anna Santamaría, Jacques Planas, Luis M. Esteban, Enrique Trilla
Cancers.2022; 14(10): 2374. CrossRef
Magnetic Resonance Imaging-Based Predictive Models for Clinically Significant Prostate Cancer: A Systematic Review
Marina Triquell, Miriam Campistol, Ana Celma, Lucas Regis, Mercè Cuadras, Jacques Planas, Enrique Trilla, Juan Morote
Cancers.2022; 14(19): 4747. CrossRef

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Diagnostic Accuracy and Value of Magnetic Resonance Imaging–Ultrasound Fusion Transperineal Targeted and Template Systematic Prostate Biopsy Based on Bi-parametric Magnetic Resonance Imaging: Tae Il Noh, Jong Hyun Tae, Hyung Keun Kim, Ji Sung Shim, Sung Gu Kang, Deuk Jae Sung, Jun Cheon, Jeong Gu Lee, Seok Ho Kang; Cancer Res Treat. 2020;52(3):714-721. Published online February 10, 2020; DOI: https://doi.org/10.4143/crt.2019.716

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Purpose
The purpose of this study was to investigate the diagnostic value of magnetic resonance imaging (MRI)–ultrasound (US) fusion transperineal targeted biopsy (FTB) and fusion template systematic biopsy (FSB) for prostate cancer (PCa) and clinically significant prostate cancer (csPCa) (intermediate/high grade [Gleason score ≥ 3+4]) based on bi-parametric MRI (bpMRI).
Materials and methods
Retrospectively, we analyzed 300 patients with elevated prostate-specific antigen (≥ 4.0 ng/mL) and/or abnormal findings in a digital rectal examination at the Korea University Hospital. All 300 men underwent bpMRI-US fusion transperineal FTB and FSB in the period from April 2017 to March 2019.
Results
PCas were detected in 158 of 300 men (52.7%), and the prevalence of csPCa was 34.0%. CsPCas were detected in 12 of 102 (11.8%) with Prostate Imaging-Reporting and Data System (PI-RADS) 3, 42 of 92 (45.7%) with PI-RADS 4, respectively; and 45 of 62 (72.6%) men with PI-RADS 5, respectively. BpMRI showed a sensitivity of 95.1% and negative predictive value of 89.6% for csPCa. FTB detected additional csPCa in 33 men (12.9%) compared to FSB. Compared to FTB, FSB detected additional csPCa in 10 men (3.9%).
Conclusion
BpMRI-US FTB and FSB improved detection of PCa and csPCa. The accuracy of bi-parametric MRI is comparable with that of multi-parametric MRI. Further, it is rapid, simpler, cheaper, and no side effects of contrast media. Therefore, it is expected that bpMRI-US transperineal FTB and FSB could be a good alternative to conventional US-guided transrectal biopsy, which is the current gold standard.

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Fusion MRI/Ultrasound-Guided Transperineal Biopsy: A Game Changer in Prostate Cancer Diagnosis
Ilias Giannakodimos, Aris Kaltsas, Napoleon Moulavasilis, Zisis Kratiras, Dionysios Mitropoulos, Michael Chrisofos, Konstantinos Stravodimos, Evangelos Fragkiadis
Journal of Clinical Medicine.2025; 14(2): 453. CrossRef
Rapid diagnostic pathways for prostate cancer: A realist synthesis
Katie Jones, Arya Chandran, Jaynie Rance
Journal of Cancer Policy.2024; 42: 100514. CrossRef
Diagnostic performance of transperineal prostate targeted biopsy alone according to the PI-RADS score based on bi-parametric magnetic resonance imaging
Tae Il Noh, Ji Sung Shim, Seok Ho Kang, Jun Cheon, Sung Gu Kang
Frontiers in Oncology.2023;[Epub] CrossRef
Efficacy of Tadalafil in Penile Rehabilitation Started Before Nerve-Sparing Robot-Assisted Radical Prostatectomy: A Double-Blind Pilot Study
Tae Il Noh, Ji Sung Shim, Sung Gu Kang, Jun Cheon, Jeong Gu Lee, Seok Ho Kang
Sexual Medicine.2022; 10(3): 1. CrossRef
Concordance between biparametric MRI, transperineal targeted plus systematic MRI-ultrasound fusion prostate biopsy, and radical prostatectomy pathology
Tae Il Noh, Ji Sung Shim, Sung Gu Kang, Jun Cheon, Jeong Gu Lee, Jeong Hyeon Lee, Seok Ho Kang
Scientific Reports.2022;[Epub] CrossRef
Three-dimensional ultrasound integrating nomogram and the blood flow image for prostate cancer diagnosis and biopsy: A retrospective study
Dong Chen, Yingjie Niu, Haitao Chen, Dequan Liu, Rong Guo, Nan Yao, Zhiyao Li, Xiaomao Luo, Hongyang Li, Shicong Tang
Frontiers in Oncology.2022;[Epub] CrossRef
Comparison between biparametric and multiparametric MRI in predicting muscle invasion by bladder cancer based on the VI-RADS
Tae Il Noh, Ji Sung Shim, Sung Gu Kang, Deuk Jae Sung, Jun Cheon, Ki Choon Sim, Seok Ho Kang
Scientific Reports.2022;[Epub] CrossRef
A Predictive Model Based on Bi-parametric Magnetic Resonance Imaging and Clinical Parameters for Clinically Significant Prostate Cancer in the Korean Population
Tae Il Noh, Chang Wan Hyun, Ha Eun Kang, Hyun Jung Jin, Jong Hyun Tae, Ji Sung Shim, Sung Gu Kang, Deuk Jae Sung, Jun Cheon, Jeong Gu Lee, Seok Ho Kang
Cancer Research and Treatment.2021; 53(4): 1148. CrossRef
PSA Based Biomarkers, Imagistic Techniques and Combined Tests for a Better Diagnostic of Localized Prostate Cancer
Vlad Cristian Munteanu, Raluca Andrada Munteanu, Diana Gulei, Vlad Horia Schitcu, Bogdan Petrut, Ioana Berindan Neagoe, Patriciu Achimas Cadariu, Ioan Coman
Diagnostics.2020; 10(10): 806. CrossRef

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Poor Preoperative Glycemic Control Is Associated with Dismal Prognosis after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Korean Multicenter Study: Sung Gu Kang, Eu Chang Hwang, Seung Il Jung, Ho Song Yu, Ho Seok Chung, Taek Won Kang, Dong Deuk Kwon, Jun Eul Hwang, Jun Seok Kim, Joon Hwa Noh, Jae Hyung You, Myung Ki Kim, Tae Hoon Oh, Ill Young Seo, Seung Baik, Chul-Sung Kim, Seok Ho Kang, Jun Cheon; Cancer Res Treat. 2016;48(4):1293-1301. Published online March 23, 2016; DOI: https://doi.org/10.4143/crt.2016.021

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Purpose
The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). Materials and Methods A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival.
Results
The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8%) had DM and 67 patients (11.8%) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95% CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95% CI, 1.40 to 3.22; p=0.001). Conclusion Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome.

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Identifying ways to improve diabetes management during cancer treatments (INDICATE): protocol for a qualitative interview study with patients and clinicians
Laura Ashley, Saifuddin Kassim, Ian Kellar, Lisa Kidd, Frances Mair, Mike Matthews, Mollie Price, Daniel Swinson, Johanna Taylor, Galina Velikova, Jonathan Wadsley
BMJ Open.2022; 12(2): e060402. CrossRef
Annular-shaped stenosis in the ureter: Caution should be taken
Jie Ming, Yue Wang, Ziliang Su, Chunyang Wang
Urologic Oncology: Seminars and Original Investigations.2022; 40(6): 274.e7. CrossRef
Glycosylated haemoglobin and prognosis in 10,536 people with cancer and pre-existing diabetes: a meta-analysis with dose-response analysis
Suping Ling, Michael Sweeting, Francesco Zaccardi, David Adlam, Umesh T. Kadam
BMC Cancer.2022;[Epub] CrossRef
Malnutrition management of hospitalized patients with diabetes/hyperglycemia and cancer cachexia
Rosa Burgos Peláez, José Pablo Suárez Llanos, Jose Manuel García Almeida, Pilar Matía Martín, Samara Palma Milla, Alejandro Sanz Paris, Ana Zugasti Murillo, Ana Artero-Fullana, Alfonso Calañas Continente, M.ª Jesús Chinchetru, Katherine García Malpartida,
Nutrición Hospitalaria.2022;[Epub] CrossRef
The Impact of Diabetes on the Prognosis of Upper Tract Urothelial Carcinoma After Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
Xiaoshuai Gao, Liang Zhou, Jianzhong Ai, Wei Wang, Xingpeng Di, Liao Peng, Banghua Liao, Xi Jin, Hong Li, Kunjie Wang
Frontiers in Oncology.2021;[Epub] CrossRef
The Prognostic Value of Lymphovascular Invasion in Patients With Upper Tract Urinary Carcinoma After Surgery: An Updated Systematic Review and Meta-Analysis
Lijin Zhang, Bin Wu, Zhenlei Zha, Hu Zhao, Jun Yuan, Yejun Feng
Frontiers in Oncology.2020;[Epub] CrossRef
The impact of preoperative glycated hemoglobin levels on outcomes in oral squamous cell carcinoma
Ze Yun Tay, Huang‐Kai Kao, Kuang‐Hsu Lien, Shao‐Yu Hung, Yenlin Huang, Ngan‐Ming Tsang, Kai‐Ping Chang
Oral Diseases.2020; 26(7): 1449. CrossRef

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Modified MVAC as a Second-Line Treatment for Patients with Metastatic Urothelial Carcinoma after Failure of Gemcitabine and Cisplatin Treatment: Jung Hyun Lee, Sung Gu Kang, Seung Tae Kim, Seok Ho Kang, In Keun Choi, Young Je Park, Sang Chul Oh, Deuk Jae Sung, Jae Hong Seo, Jun Cheon, Sang Won Shin, Yeul Hong Kim, Jun Suk Kim, Kyong Hwa Park; Cancer Res Treat. 2014;46(2):172-177. Published online April 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.2.172

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Purpose

There is no established standard second-line chemotherapy for patients with advanced or metastatic urothelial carcinoma (UC) who failed gemcitabine and cisplatin (GC) chemotherapy. This study was conducted in order to investigate the efficacy and toxicity of modified methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with metastatic UC previously treated with GC.

Materials and Methods

We retrospectively analyzed 28 patients who received modified MVAC between November 2004 and November 2012. All patients failed prior, first-line GC chemotherapy.

Results

The median age of patients was 64.0 years (range, 33.0 to 77.0 years), and 23 (82.1%) patients had an Eastern Cooperative Oncology Group performance status of 0 or 1. The overall response rate and the disease control rate were 36.0% and 64.0%, respectively. After a median follow-up period of 38 weeks (range, 5 to 182 weeks), median progression free survival was 21.0 weeks (95% confidence interval [CI], 6.3 to 35.7 weeks) and median overall survival was 49.0 weeks (95% CI, 18.8 to 79.3 weeks). Grade 3 or 4 hematological toxicities included neutropenia (n=21, 75.0%) and anemia (n=9, 32.1%). Grade 3 or 4 non-hematological toxicities did not occur and there was no treatment-related death.

Conclusion

Modified MVAC appears to be a safe and active chemotherapy regimen in patients with stable physical status and adequate renal function after GC treatment.

Citations

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Chronological transition in outcome of second-line treatment in patients with metastatic urothelial cancer after pembrolizumab approval: a multicenter retrospective analysis
Teruki Isobe, Taku Naiki, Yosuke Sugiyama, Aya Naiki-Ito, Takashi Nagai, Toshiki Etani, Satoshi Nozaki, Keitaro Iida, Yusuke Noda, Nobuhiko Shimizu, Nami Tomiyama, Rika Banno, Hiroki Kubota, Shuzo Hamamoto, Ryosuke Ando, Noriyasu Kawai, Takahiro Yasui
International Journal of Clinical Oncology.2022; 27(1): 165. CrossRef
SIU-ICUD recommendations on bladder cancer: systemic therapy for metastatic bladder cancer
Axel S. Merseburger, Andrea B. Apolo, Simon Chowdhury, Noah M. Hahn, Matthew D. Galsky, Matthew I. Milowsky, Daniel Petrylak, Tom Powles, David I. Quinn, Jonathan E. Rosenberg, Arlene Siefker-Radtke, Guru Sonpavde, Cora N. Sternberg
World Journal of Urology.2019; 37(1): 95. CrossRef
Efficacy of Different Second-line Therapy Regimens in Metastatic Urothelial Carcinoma
Lukas Barwitz, Anne Berger, Stefanie Zschaebitz, Max Jenzer, Cathleen Nientiedt, Stefan Duensing, Dirk Jäger, Dogu Teber, Markus Hohenfellner, Carsten Grüllich
The Open Urology & Nephrology Journal.2017; 10(1): 52. CrossRef
Cisplatin- Versus Non–Cisplatin-based First-Line Chemotherapy for Advanced Urothelial Carcinoma Previously Treated With Perioperative Cisplatin
Jennifer A. Locke, Gregory Russell Pond, Guru Sonpavde, Andrea Necchi, Patrizia Giannatempo, Ravi Kumar Paluri, Guenter Niegisch, Peter Albers, Carlo Buonerba, Giuseppe Di Lorenzo, Ulka N. Vaishampayan, Scott A. North, Neeraj Agarwal, Syed A. Hussain, Sum
Clinical Genitourinary Cancer.2016; 14(4): 331. CrossRef
Second Line Chemotherapy for Advanced and Metastatic Urothelial Carcinoma: Vinflunine and Beyond—A Comprehensive Review of the Current Literature
Christoph Oing, Michael Rink, Karin Oechsle, Christoph Seidel, Gunhild von Amsberg, Carsten Bokemeyer
Journal of Urology.2016; 195(2): 254. CrossRef
Predicting the response of patients with advanced urothelial cancer to methotrexate, vinblastine, Adriamycin, and cisplatin (MVAC) after the failure of gemcitabine and platinum (GP)
Ki Hong Kim, Sung Joon Hong, Kyung Seok Han
BMC Cancer.2015;[Epub] CrossRef

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Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy: Hoon Choi, Young Hwii Ko, Sung Gu Kang, Seok Ho Kang, Hong Seok Park, Jun Cheon, Vipul R. Patel; Cancer Res Treat. 2009;41(4):205-210. Published online December 31, 2009; DOI: https://doi.org/10.4143/crt.2009.41.4.205

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Purpose

To determine whether the biopsy core number and time interval between prostate biopsy and radical prostatectomy affect the operative and oncologic outcome of robot assisted laparoscopic radical prostatectomy (RALP).

Materials and Methods

From January 2008 to April 2009, a single surgeon performed 72 RALPs after an initial learning period of 30 cases. The relationship between time from biopsy to prostatectomy and biopsy core number with operative time and estimated blood loss (EBL) were initially evaluated with a linear regression model. These patients were classified into groups according to whether the interval from biopsy to RALP was within four weeks or not, and whether there were less than or greater than 10 core specimens removed.

Results

RALP was performed in 34 patients within four weeks of biopsy, and in 38 patients more than 4 weeks after biopsy. According to the number of core specimens removed, less than 10 cores were performed in 10 patients, and more than 10 cores were performed in 62 patients. Using an interval of 4 weeks as the cutoff point, early surgery was associated with longer operating time (232.6 vs 208.8 min) and increased estimated blood loss (305.1 vs 276.9 mL). For cases with more than 10 biopsy cores, there was a slight increase in operative time (229.2 vs 210.3 min). None of these differences were statistically significant by multivariate analysis.

Conclusion

Our data suggests that there is no reason to delay RALP to more than 4 weeks after prostate biopsy. It also revealed that the number of biopsy cores (up to 14) did not influence operative outcome. Thus, RALP is a feasible procedure regardless of the biopsy related prostate state.

Citations

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Effect of Transperineal Versus Transrectal Prostate Biopsy on the Quality of Hydrogel Spacer Placement in Men Prior to Radiation Therapy for Prostate Cancer
Michael E. Rezaee, Ulysses Gardner, Mark N. Alshak, Stephen C. Greco, Daniel Y. Song, Michael Goldstein, Christian P. Pavlovich
Urology.2023; 182: 27. CrossRef
Does time interval between prostate biopsy and surgery affect outcomes of radical prostatectomy? A systematic review and meta-analysis
Jie Li, Qing Jiang, Qiubo Li, Yuanfeng Zhang, Liang Gao
International Urology and Nephrology.2020; 52(4): 619. CrossRef
Short interval of biopsy to robotic-assisted laparoscopic radical prostatectomy does not render any adverse effects on the perioperative outcomes
Minke He, Yaohui Li, Zhuoyi Xiang, Li-an Sun, Yanjun Zhu, Xiaoyi Hu, Jianming Guo, Hang Wang
Medicine.2018; 97(36): e11686. CrossRef
A Multidimensional Analysis of Prostate Surgery Costs in the United States: Robotic-Assisted versus Retropubic Radical Prostatectomy
Akash Bijlani, April E. Hebert, Mike Davitian, Holly May, Mark Speers, Robert Leung, Nihal E. Mohamed, Henry S. Sacks, Ashutosh Tewari
Value in Health.2016; 19(4): 391. CrossRef
Interval from Prostate Biopsy to Radical Prostatectomy Does Not Affect Immediate Operative Outcomes for Open or Minimally Invasive Approach
Bumsoo Park, Seol Ho Choo, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi
Journal of Korean Medical Science.2014; 29(12): 1688. CrossRef
Interval from Prostate Biopsy to Robot-Assisted Laparoscopic Radical Prostatectomy (RALP): Effects on Surgical Difficulties
In Sung Kim, Woong Na, Jung Su Nam, Jong Jin Oh, Chang Wook Jeong, Sung Kyu Hong, Seok Soo Byun, Sang Eun Lee
Korean Journal of Urology.2011; 52(10): 664. CrossRef
Prostate-Specific Antigen Density as a Powerful Predictor of Extracapsular Extension and Positive Surgical Margin in Radical Prostatectomy Patients with Prostate-Specific Antigen Levels of Less than 10 ng/ml
Jin-Seok Chang, Hoon Choi, Young-Seop Chang, Jin-Bum Kim, Mi Mi Oh, Du Geon Moon, Jae Hyun Bae, Jun Cheon
Korean Journal of Urology.2011; 52(12): 809. CrossRef

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