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Erschienen in: World Journal of Urology 2/2009

01.04.2009 | Original Article

Prediction of Gleason score upgrading in low-risk prostate cancers diagnosed via multi (≥12)-core prostate biopsy

verfasst von: Sung Kyu Hong, Byung Kyu Han, Seung Tae Lee, Sung Soo Kim, Kyung Eun Min, Sung Jin Jeong, Hyeon Jeong, Seok-Soo Byun, Hak Jong Lee, Gheeyoung Choe, Sang Eun Lee

Erschienen in: World Journal of Urology | Ausgabe 2/2009

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Abstract

Objectives

A paucity of data exists on actual pathology of the contemporary patients strictly categorized as having low-risk prostate cancer. We tried to identify useful preoperative predictors of Gleason score upgrading in patients who underwent radical retropubic prostatectomy (RRP) for low-risk prostate cancer diagnosed via multi-core prostate biopsy.

Methods

A total of 203 patients who underwent radical RRP for low-risk prostate cancer, as defined by D’Amico et al.'s classification (clinical stage ≤T2a, biopsy Gleason sum ≤6, and PSA ≤10 ng/ml), detected via multi (≥12)-core prostate biopsy were enrolled. We reviewed patients preoperative and pathological data.

Results

Among all subjects, 81 (39.9%) were upgraded to Gleason score ≥7 after RRP, whereas no downgrading was observed. In multivariate analysis, only preoperative PSA level (= 0.024) and number of positive cores (P = 0.027) were observed to be independent predictors of Gleason score upgrading following RRP. Also, Gleason core upgrading was observed to be significantly associated with extraprostatic extension of tumor (P < 0.001) and positive surgical margin (P = 0.002).

Conclusions

A significant proportion of patients with low-risk prostate cancer as defined by D’Amico et al.’s classification diagnosed via multi-core prostate biopsy in contemporary period may have Gleason score upgrading following RRP. For patients with low-risk prostate cancer, preoperative PSA level and number of positive cores may be useful predictors of Gleason score upgrading, which was observed to significantly associated with other adverse pathologic features.
Literatur
1.
Zurück zum Zitat D’Amico AV, Whittington R, Malkowicz SB et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974. doi:10.1001/jama.280.11.969 PubMedCrossRef D’Amico AV, Whittington R, Malkowicz SB et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974. doi:10.​1001/​jama.​280.​11.​969 PubMedCrossRef
6.
Zurück zum Zitat Bostwick DG (1994) Gleason grading of prostatic needle biopsies. Correlation with grade in 316 matched prostatectomies. Am J Surg Pathol 18:796–803PubMedCrossRef Bostwick DG (1994) Gleason grading of prostatic needle biopsies. Correlation with grade in 316 matched prostatectomies. Am J Surg Pathol 18:796–803PubMedCrossRef
8.
Zurück zum Zitat Kulkarni GS, Lockwood G, Evans A et al (2007) Clinical predictors of Gleason score upgrading: implications for patients considering watchful waiting, active surveillance, or brachytherapy. Cancer 109:2432–2438. doi:10.1002/cncr.22712 PubMedCrossRef Kulkarni GS, Lockwood G, Evans A et al (2007) Clinical predictors of Gleason score upgrading: implications for patients considering watchful waiting, active surveillance, or brachytherapy. Cancer 109:2432–2438. doi:10.​1002/​cncr.​22712 PubMedCrossRef
11.
13.
Zurück zum Zitat D’Amico AV, Renshaw AA, Arsenault L, Schultz D, Richie JP (1999) Clinical predictors of upgrading to Gleason grade 4 or 5 disease at radical prostatectomy: potential implications for patient selection for radiation and androgen suppression therapy. Int J Radiat Oncol Biol Phys 45:841–846. doi:10.1016/S0360-3016(99)00260-6 PubMed D’Amico AV, Renshaw AA, Arsenault L, Schultz D, Richie JP (1999) Clinical predictors of upgrading to Gleason grade 4 or 5 disease at radical prostatectomy: potential implications for patient selection for radiation and androgen suppression therapy. Int J Radiat Oncol Biol Phys 45:841–846. doi:10.​1016/​S0360-3016(99)00260-6 PubMed
17.
Zurück zum Zitat King CR, McNeal JE, Gill H, Presti JC Jr (2004) Extended prostate biopsy scheme improves reliability of Gleason grading: implications for radiotherapy patients. Int J Radiat Oncol Biol Phys 59:386–391. doi:10.1016/j.ijrobp.2003.10.014 PubMed King CR, McNeal JE, Gill H, Presti JC Jr (2004) Extended prostate biopsy scheme improves reliability of Gleason grading: implications for radiotherapy patients. Int J Radiat Oncol Biol Phys 59:386–391. doi:10.​1016/​j.​ijrobp.​2003.​10.​014 PubMed
Metadaten
Titel
Prediction of Gleason score upgrading in low-risk prostate cancers diagnosed via multi (≥12)-core prostate biopsy
verfasst von
Sung Kyu Hong
Byung Kyu Han
Seung Tae Lee
Sung Soo Kim
Kyung Eun Min
Sung Jin Jeong
Hyeon Jeong
Seok-Soo Byun
Hak Jong Lee
Gheeyoung Choe
Sang Eun Lee
Publikationsdatum
01.04.2009
Verlag
Springer-Verlag
Erschienen in
World Journal of Urology / Ausgabe 2/2009
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-008-0343-3

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