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Prognostic significance of Gleason score discrepancies between needle biopsy and radical prostatectomy.
Eur Urol. 2008 Apr; 53(4):767-75; discussion 775-6.EU

Abstract

OBJECTIVES

Discordance between the Gleason score (GS) on needle biopsy (NB) and the GS of the radical prostatectomy (RP) specimen is a common finding. The objective of this study was to evaluate the prognostic significance of these discrepancies with respect to outcomes following RP.

METHODS

In the study, 6625 men treated by RP were categorized as having NB=RP (68.8%), NB<RP (25.0%) or NB>RP (6.2%) GS, and stratified for analyses into RP GS groups. The Kaplan-Meier method was used to analyze differences in biochemical recurrence-free survival (BRFS), and multivariate Cox analyses were performed to estimate the independent relative risk of progression associated with GS discrepancies.

RESULTS

Across multiple RP GS strata (3+4, 7, 8, 8-10), patients with a lower NB GS experienced significantly better BRFS than patients with equal NB and RP GS (all p<0.05). NB<RP GS was independently associated with better (pooled HR, 0.76, p=0.001) BRFS, within and across RP GS strata. Similarly, patients with NB>RP GS had poorer BRFS than patients with NB=RP GS across multiple RP GS strata (< or =3+3, 3+4, 7; all p<0.05). NB>RP GS was independently associated with worse (pooled HR, 1.91, p<0.001) BRFS probabilities, within and across RP GS strata.

CONCLUSIONS

Our data suggest that the GS of the NB adds additional prognostic value to the RP GS in a consistent manner that may be applicable to strategies of risk stratification and patient counseling after surgery.

Authors+Show Affiliations

Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA. michael.muentener@usz.ch <michael.muentener@usz.ch>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18060681

Citation

Müntener, Michael, et al. "Prognostic Significance of Gleason Score Discrepancies Between Needle Biopsy and Radical Prostatectomy." European Urology, vol. 53, no. 4, 2008, pp. 767-75; discussion 775-6.
Müntener M, Epstein JI, Hernandez DJ, et al. Prognostic significance of Gleason score discrepancies between needle biopsy and radical prostatectomy. Eur Urol. 2008;53(4):767-75; discussion 775-6.
Müntener, M., Epstein, J. I., Hernandez, D. J., Gonzalgo, M. L., Mangold, L., Humphreys, E., Walsh, P. C., Partin, A. W., & Nielsen, M. E. (2008). Prognostic significance of Gleason score discrepancies between needle biopsy and radical prostatectomy. European Urology, 53(4), 767-75; discussion 775-6.
Müntener M, et al. Prognostic Significance of Gleason Score Discrepancies Between Needle Biopsy and Radical Prostatectomy. Eur Urol. 2008;53(4):767-75; discussion 775-6. PubMed PMID: 18060681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic significance of Gleason score discrepancies between needle biopsy and radical prostatectomy. AU - Müntener,Michael, AU - Epstein,Jonathan I, AU - Hernandez,David J, AU - Gonzalgo,Mark L, AU - Mangold,Leslie, AU - Humphreys,Elizabeth, AU - Walsh,Patrick C, AU - Partin,Alan W, AU - Nielsen,Matthew E, Y1 - 2007/11/20/ PY - 2007/08/21/received PY - 2007/11/06/accepted PY - 2007/12/7/pubmed PY - 2008/6/27/medline PY - 2007/12/7/entrez SP - 767-75; discussion 775-6 JF - European urology JO - Eur Urol VL - 53 IS - 4 N2 - OBJECTIVES: Discordance between the Gleason score (GS) on needle biopsy (NB) and the GS of the radical prostatectomy (RP) specimen is a common finding. The objective of this study was to evaluate the prognostic significance of these discrepancies with respect to outcomes following RP. METHODS: In the study, 6625 men treated by RP were categorized as having NB=RP (68.8%), NB<RP (25.0%) or NB>RP (6.2%) GS, and stratified for analyses into RP GS groups. The Kaplan-Meier method was used to analyze differences in biochemical recurrence-free survival (BRFS), and multivariate Cox analyses were performed to estimate the independent relative risk of progression associated with GS discrepancies. RESULTS: Across multiple RP GS strata (3+4, 7, 8, 8-10), patients with a lower NB GS experienced significantly better BRFS than patients with equal NB and RP GS (all p<0.05). NB<RP GS was independently associated with better (pooled HR, 0.76, p=0.001) BRFS, within and across RP GS strata. Similarly, patients with NB>RP GS had poorer BRFS than patients with NB=RP GS across multiple RP GS strata (< or =3+3, 3+4, 7; all p<0.05). NB>RP GS was independently associated with worse (pooled HR, 1.91, p<0.001) BRFS probabilities, within and across RP GS strata. CONCLUSIONS: Our data suggest that the GS of the NB adds additional prognostic value to the RP GS in a consistent manner that may be applicable to strategies of risk stratification and patient counseling after surgery. SN - 0302-2838 UR - https://www.unboundmedicine.com/medline/citation/18060681/Prognostic_significance_of_Gleason_score_discrepancies_between_needle_biopsy_and_radical_prostatectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(07)01433-9 DB - PRIME DP - Unbound Medicine ER -