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Prostate cancer volume at biopsy predicts clinically significant upgrading.
J Urol. 2008 Mar; 179(3):896-900; discussion 900.JU

Abstract

PURPOSE

A significant proportion of patients with prostate cancer with Gleason score 6 disease at biopsy is upgraded to Gleason score 7 or higher after radical prostatectomy, increasing the risk of adverse outcome. We identified clinical and pathological parameters that predict pathological upgrading in this population.

MATERIALS AND METHODS

A total of 268 patients with biopsy Gleason score 6 prostate cancer who underwent biopsy and radical prostatectomy between October 1999 and January 2007 were included in the study. Pretreatment characteristics were used to identify predictors of pathological upgrading. Upgrading significance was established by comparing radical prostatectomy pathology between cases that were and were not upgraded.

RESULTS

A total of 134 patients (50%) were upgraded postoperatively to Gleason score 7 or higher. Preoperative prostate specific antigen greater than 5.0 ng/ml (p = 0.036), prostate weight 60 gm or less (p = 0.004) and more cancer volume at biopsy, defined by cancer involving greater than 5% of the biopsy tissue (p = 0.002), greater than 1 biopsy core (p <0.001) or greater than 10% of any core (p = 0.014), were associated with pathological upgrading. Upgraded patients were more likely to have extraprostatic extension and positive surgical margins at radical prostatectomy (p <0.001 and 0.001, respectively).

CONCLUSIONS

Prostate specific antigen, prostate volume and biopsy cancer volume predict clinically significant upgrading in patients diagnosed with Gleason score 6 disease. These parameters may be valuable in the pretreatment risk assessment of this patient population.

Authors+Show Affiliations

Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18207180

Citation

Dong, Fei, et al. "Prostate Cancer Volume at Biopsy Predicts Clinically Significant Upgrading." The Journal of Urology, vol. 179, no. 3, 2008, pp. 896-900; discussion 900.
Dong F, Jones JS, Stephenson AJ, et al. Prostate cancer volume at biopsy predicts clinically significant upgrading. J Urol. 2008;179(3):896-900; discussion 900.
Dong, F., Jones, J. S., Stephenson, A. J., Magi-Galluzzi, C., Reuther, A. M., & Klein, E. A. (2008). Prostate cancer volume at biopsy predicts clinically significant upgrading. The Journal of Urology, 179(3), 896-900; discussion 900. https://doi.org/10.1016/j.juro.2007.10.060
Dong F, et al. Prostate Cancer Volume at Biopsy Predicts Clinically Significant Upgrading. J Urol. 2008;179(3):896-900; discussion 900. PubMed PMID: 18207180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prostate cancer volume at biopsy predicts clinically significant upgrading. AU - Dong,Fei, AU - Jones,J Stephen, AU - Stephenson,Andrew J, AU - Magi-Galluzzi,Cristina, AU - Reuther,Alwyn M, AU - Klein,Eric A, Y1 - 2008/01/22/ PY - 2007/07/05/received PY - 2008/1/22/pubmed PY - 2008/3/20/medline PY - 2008/1/22/entrez SP - 896-900; discussion 900 JF - The Journal of urology JO - J Urol VL - 179 IS - 3 N2 - PURPOSE: A significant proportion of patients with prostate cancer with Gleason score 6 disease at biopsy is upgraded to Gleason score 7 or higher after radical prostatectomy, increasing the risk of adverse outcome. We identified clinical and pathological parameters that predict pathological upgrading in this population. MATERIALS AND METHODS: A total of 268 patients with biopsy Gleason score 6 prostate cancer who underwent biopsy and radical prostatectomy between October 1999 and January 2007 were included in the study. Pretreatment characteristics were used to identify predictors of pathological upgrading. Upgrading significance was established by comparing radical prostatectomy pathology between cases that were and were not upgraded. RESULTS: A total of 134 patients (50%) were upgraded postoperatively to Gleason score 7 or higher. Preoperative prostate specific antigen greater than 5.0 ng/ml (p = 0.036), prostate weight 60 gm or less (p = 0.004) and more cancer volume at biopsy, defined by cancer involving greater than 5% of the biopsy tissue (p = 0.002), greater than 1 biopsy core (p <0.001) or greater than 10% of any core (p = 0.014), were associated with pathological upgrading. Upgraded patients were more likely to have extraprostatic extension and positive surgical margins at radical prostatectomy (p <0.001 and 0.001, respectively). CONCLUSIONS: Prostate specific antigen, prostate volume and biopsy cancer volume predict clinically significant upgrading in patients diagnosed with Gleason score 6 disease. These parameters may be valuable in the pretreatment risk assessment of this patient population. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/18207180/Prostate_cancer_volume_at_biopsy_predicts_clinically_significant_upgrading_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2007.10.060?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -