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Prognostic Impact of Different Gleason Patterns on Biopsy Within Grade Group 4 Prostate Cancer
K. Mori, V. Sharma, EM. Comperat, S. Sato, E. Laukhtina, VM. Schuettfort, B. Pradere, R. Sari Motlagh, H. Mostafaei, F. Quhal, M. Kardoust Parizi, M. Abufaraj, PI. Karakiewicz, S. Egawa, D. Tilki, SA. Boorjian, SF. Shariat
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
NLK
Free Medical Journals
od 1994 do Před 24 měsíci
ProQuest Central
od 1997-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2009-07-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1997-01-01 do Před 1 rokem
- MeSH
- biopsie MeSH
- lidé MeSH
- nádory prostaty * chirurgie MeSH
- prognóza MeSH
- prostatektomie * MeSH
- prostatický specifický antigen MeSH
- retrospektivní studie MeSH
- stupeň nádoru MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: Grade group (GG) 4 prostate cancer (PC) is considered a single entity; however, there are questions regarding prognostic heterogeneity. This study assessed the prognostic differences among various Gleason scores (GSs) classified as GG 4 PC on biopsy before radical prostatectomy (RP). METHODS: We conducted a multicenter retrospective study, and a total of 1791 patients (GS 3 + 5: 190; GS 4 + 4: 1557; and GS 5 + 3: 44) with biopsy GG 4 were included for analysis. Biochemical recurrence (BCR)-free survival, cancer-specific survival, and overall survival were analyzed using the Kaplan-Meier method and the log-rank test. Logistic regression analysis was performed to identify factors associated with high-risk surgical pathologic features. Cox regression models were used to analyze time-dependent oncologic endpoints. RESULTS: Over a median follow-up of 75 months, 750 patients (41.9%) experienced BCR, 146 (8.2%) died of any causes, and 57 (3.2%) died of PC. Biopsy GS 5 + 3 was associated with significantly higher rates of GS upgrading in RP specimens than GS 3 + 5 and GS 4 + 4. On multivariable analysis adjusted for clinicopathologic features, different GSs within GG 4 were significantly associated with BCR (p = 0.03) but not PC-specific or all-cause mortality. Study limitations include the lack of central pathological specimen evaluation. CONCLUSIONS: Patients with GG 4 at biopsy exhibited some limited biological and clinical heterogeneity. Specifically, GS 5 + 3 had an increased risk of GS upgrading. This can help individualize patients' counseling and encourage further study to refine biopsy specimen-based GG classification.
Cancer Prognostics and Health Outcomes Unit University of Montreal Health Centre Montreal QC Canada
Department of Pathology Hôpital Tenon Sorbonne University Paris France
Department of Pathology The Jikei University School of Medicine Tokyo Japan
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology King Fahad Specialist Hospital Dammam Saudi Arabia
Department of Urology Mayo Clinic Rochester MN USA
Department of Urology Medical University of Vienna Vienna Austria
Department of Urology Shariati Hospital Tehran University of Medical Sciences Tehran Iran
Department of Urology The Jikei University School of Medicine Tokyo Japan
Department of Urology University Hospital Hamburg Eppendorf Hamburg Germany
Department of Urology University Hospital of Tours Tours France
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University of Texas Southwestern Dallas TX USA
Department of Urology Weill Cornell Medical College New York NY USA
Division of Urology Department of Special Surgery The University of Jordan Amman Jordan
European Association of Urology Research Foundation Arnhem The Netherlands
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Martini Klinik Prostate Cancer Center University Hospital Hamburg Eppendorf Hamburg Germany
Research Center for Evidence Based Medicine Tabriz University of Medical Sciences Tabriz Iran
Citace poskytuje Crossref.org
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- $a BACKGROUND: Grade group (GG) 4 prostate cancer (PC) is considered a single entity; however, there are questions regarding prognostic heterogeneity. This study assessed the prognostic differences among various Gleason scores (GSs) classified as GG 4 PC on biopsy before radical prostatectomy (RP). METHODS: We conducted a multicenter retrospective study, and a total of 1791 patients (GS 3 + 5: 190; GS 4 + 4: 1557; and GS 5 + 3: 44) with biopsy GG 4 were included for analysis. Biochemical recurrence (BCR)-free survival, cancer-specific survival, and overall survival were analyzed using the Kaplan-Meier method and the log-rank test. Logistic regression analysis was performed to identify factors associated with high-risk surgical pathologic features. Cox regression models were used to analyze time-dependent oncologic endpoints. RESULTS: Over a median follow-up of 75 months, 750 patients (41.9%) experienced BCR, 146 (8.2%) died of any causes, and 57 (3.2%) died of PC. Biopsy GS 5 + 3 was associated with significantly higher rates of GS upgrading in RP specimens than GS 3 + 5 and GS 4 + 4. On multivariable analysis adjusted for clinicopathologic features, different GSs within GG 4 were significantly associated with BCR (p = 0.03) but not PC-specific or all-cause mortality. Study limitations include the lack of central pathological specimen evaluation. CONCLUSIONS: Patients with GG 4 at biopsy exhibited some limited biological and clinical heterogeneity. Specifically, GS 5 + 3 had an increased risk of GS upgrading. This can help individualize patients' counseling and encourage further study to refine biopsy specimen-based GG classification.
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