Tags

Type your tag names separated by a space and hit enter

Patient risk stratification using Gleason score concordance and upgrading among men with prostate biopsy Gleason score 6 or 7.
Urol Oncol. 2010 May-Jun; 28(3):302-7.UO

Abstract

PURPOSE

To define the impact of discordant Gleason sum (GS) between prostate biopsy (Pbx) tissue and radical prostatectomy (RP) specimen among men initially diagnosed with Gleason 6 or 7 prostate adenocarcinoma.

MATERIALS AND METHODS

We evaluated patients diagnosed with GS 6 or 7 and treated primarily with RP. We defined the frequency of GS discordance between Pbx and RP pathology reports. We analyzed pretreatment parameters associated with GS discordance and compared immediate postprostatectomy outcome variables across patient groups defined by their GS and concordance. We then conducted survival analysis for biochemical recurrence across patient groups defined by their GS and concordance status.

RESULTS

Among patients with GS 6 on Pbx, 681/1,847 (36.86%) patients were upgraded to GS 7 or higher after RP. Surgical margin, capsular involvement, seminal vesicle, and nodal involvement status were more favorable in patients with concordant Pbx and RP specimen with GS 6 (P < 0.0001). Patients with smaller transrectal ultrasound (TRUS) prostate volume were found to have higher PSA densities and were more likely to be upgraded at RP. Multivariate survival analysis also predicted fewer biochemical recurrence events over time in men with concordant Pbx tissue and RP specimen of GS 6 vs. 6/7 or 7/7 (P = 0.0025) controlling for other relevant covariates.

CONCLUSIONS

GS discordance between Pbx tissue and RP specimens among prostate cancer patients initially diagnosed with either GS 6 or 7 adenocarcinoma of the prostate is substantial. This discordance has potential clinical significance in predicting oncologic outcomes.

Authors+Show Affiliations

Department of Surgery, Urology Service, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19117774

Citation

Serkin, Faye B., et al. "Patient Risk Stratification Using Gleason Score Concordance and Upgrading Among Men With Prostate Biopsy Gleason Score 6 or 7." Urologic Oncology, vol. 28, no. 3, 2010, pp. 302-7.
Serkin FB, Soderdahl DW, Cullen J, et al. Patient risk stratification using Gleason score concordance and upgrading among men with prostate biopsy Gleason score 6 or 7. Urol Oncol. 2010;28(3):302-7.
Serkin, F. B., Soderdahl, D. W., Cullen, J., Chen, Y., & Hernandez, J. (2010). Patient risk stratification using Gleason score concordance and upgrading among men with prostate biopsy Gleason score 6 or 7. Urologic Oncology, 28(3), 302-7. https://doi.org/10.1016/j.urolonc.2008.09.030
Serkin FB, et al. Patient Risk Stratification Using Gleason Score Concordance and Upgrading Among Men With Prostate Biopsy Gleason Score 6 or 7. Urol Oncol. 2010 May-Jun;28(3):302-7. PubMed PMID: 19117774.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient risk stratification using Gleason score concordance and upgrading among men with prostate biopsy Gleason score 6 or 7. AU - Serkin,Faye B, AU - Soderdahl,Douglas W, AU - Cullen,Jennifer, AU - Chen,Yongmei, AU - Hernandez,Javier, Y1 - 2008/12/30/ PY - 2008/07/01/received PY - 2008/09/24/revised PY - 2008/09/25/accepted PY - 2009/1/2/entrez PY - 2009/1/2/pubmed PY - 2010/7/31/medline SP - 302 EP - 7 JF - Urologic oncology JO - Urol Oncol VL - 28 IS - 3 N2 - PURPOSE: To define the impact of discordant Gleason sum (GS) between prostate biopsy (Pbx) tissue and radical prostatectomy (RP) specimen among men initially diagnosed with Gleason 6 or 7 prostate adenocarcinoma. MATERIALS AND METHODS: We evaluated patients diagnosed with GS 6 or 7 and treated primarily with RP. We defined the frequency of GS discordance between Pbx and RP pathology reports. We analyzed pretreatment parameters associated with GS discordance and compared immediate postprostatectomy outcome variables across patient groups defined by their GS and concordance. We then conducted survival analysis for biochemical recurrence across patient groups defined by their GS and concordance status. RESULTS: Among patients with GS 6 on Pbx, 681/1,847 (36.86%) patients were upgraded to GS 7 or higher after RP. Surgical margin, capsular involvement, seminal vesicle, and nodal involvement status were more favorable in patients with concordant Pbx and RP specimen with GS 6 (P < 0.0001). Patients with smaller transrectal ultrasound (TRUS) prostate volume were found to have higher PSA densities and were more likely to be upgraded at RP. Multivariate survival analysis also predicted fewer biochemical recurrence events over time in men with concordant Pbx tissue and RP specimen of GS 6 vs. 6/7 or 7/7 (P = 0.0025) controlling for other relevant covariates. CONCLUSIONS: GS discordance between Pbx tissue and RP specimens among prostate cancer patients initially diagnosed with either GS 6 or 7 adenocarcinoma of the prostate is substantial. This discordance has potential clinical significance in predicting oncologic outcomes. SN - 1873-2496 UR - https://www.unboundmedicine.com/medline/citation/19117774/Patient_risk_stratification_using_Gleason_score_concordance_and_upgrading_among_men_with_prostate_biopsy_Gleason_score_6_or_7_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-1439(08)00248-2 DB - PRIME DP - Unbound Medicine ER -