Predictive value of primary Gleason pattern 4 in patients with Gleason score 7 tumours treated with radical prostatectomy

BJU International
Seyed M KhoddamiKenneth S Koeneman

Abstract

To examine whether Gleason score (GS) 3 + 4 and 4 + 3 cancers at radical prostatectomy behave differently and whether this behaviour is independently associated with prostate cancer outcome. From July 1994 to December 2002 309 consecutive men who had a radical retropubic prostatectomy for clinically localized disease had final GS 7 tumours in their prostatectomy specimen. Statistical analyses, including multivariate logistic regression, were used to evaluate the association between variables, i.e. standard preoperative features, stage, PSA progression, standard pathological variables, metastasis and death. In all, 215 patients (70%) had a final GS of 3 + 4 and 94 (30%) of 4 + 3. A final GS of 4 + 3 was associated with clinical stage T2 disease (P = 0.024), a higher biopsy GS (P < 0.001), seminal vesicle involvement (P < 0.001), positive surgical margins (P = 0.036), lymphovascular invasion (P = 0.018), metastases to regional lymph nodes (P = 0.008), higher preoperative serum prostate-specific antigen (PSA) (P = 0.042), and percentage positive biopsy cores (P = 0.006). In univariate analysis, patients with GS 4 + 3 had a significantly higher risk of biochemical progression than those with GS 3 + 4 (P = 0.002). The 5-year actuari...Continue Reading

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Citations

May 13, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jennifer R StarkLorelei A Mucci
Dec 17, 2009·Future Oncology·Shahrokh F ShariatPeter T Scardino
Jun 15, 2013·Seminars in Radiation Oncology·Juanita Crook, Ana Fernandez Ots
Oct 31, 2008·International Journal of Radiation Oncology, Biology, Physics·Michael J BurdickJay P Ciezki
Feb 16, 2011·BJU International·Sheng F OonJohn M Fitzpatrick
Sep 9, 2008·Urologic Oncology·Marklyn J Jones, Kenneth S Koeneman
Apr 9, 2009·Nature Reviews. Urology·Vladimir MouravievThomas J Polascik
Oct 16, 2020·Scientific Reports·Lina Maria Carmona EcheverriaHayley C Whitaker
Jun 13, 2021·Annals of Surgical Oncology·Keiichiro MoriShahrokh F Shariat

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