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SHR Neuro Cancer Cardio Lipid Metab Microb

Isbarn, H; Karakiewicz, PI; Ahyai, SA; Chun, FK; Jeldres, C; Haese, A; Heinzer, H; Zacharias, M; Heuer, R; Eichelberg, C; Steuber, T; Budäus, L; Köllermann, J; Salomon, G; Schlomm, T; Perrotte, P; Fisch, M; Huland, H; Graefen, M.
Differences in histopathological and biochemical outcomes in patients with low Gleason score prostate cancer.
BJU Int. 2010; 105(6):818-23 Doi: 10.1111/j.1464-410X.2009.08841.x
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Ahyai Sascha
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Abstract:: STUDY TYPE: Diagnosis (case series). LEVEL OF EVIDENCE: 4. OBJECTIVE: To test whether the number or percentage of positive biopsy cores can be used to discriminate between patients with prostate cancer of a favourable and less favourable Gleason score (GS) < or =3 + 3, as prognostically, not all GS 3 + 3 prostate cancers are the same. PATIENTS AND METHODS: In all, 1106 consecutive patients with a prostate-specific antigen (PSA) level of < or =10 ng/mL and a biopsy GS of < or =3 + 3 or 3 + 4 had an open radical prostatectomy. The number of positive biopsy cores (< or =2 vs > or =3) were stratified into low- vs high-risk groups. Subsequently, we stratified patients according to the GS and the percentage of positive biopsy cores (<50% vs > or =50%). The pathological stage and the 5-year biochemical recurrence (BCR)-free survival rates were examined in univariable and multivariable models. RESULTS: Based on the number of positive cores, the rate of extraprostatic disease was 11.7% and 23.3%, respectively, in the low-and high-risk GS < or =3 + 3 groups (P < 0.001). The 5-year BCR-free survival rates were 95.0%, 77.8%, 81.2% and 66.5% for, respectively, low- and high-risk GS < or =3 + 3 and for low- and high-risk GS 3 + 4 patients. Univariable and multivariable intergroup BCR rate differences were statistically significant between low- vs high-risk GS 3 + 3 patients (P < 0.001), but not significant between high-risk GS < or =3 + 3 vs low-risk GS 3 + 4 patients (P = 0.6). Comparable results were obtained when comparisons were made according to the percentage of positive biopsy cores. CONCLUSIONS: Our results corroborate the finding that not all patients with a biopsy GS of < or =3 + 3 prostate cancer have low-risk disease. High-risk GS < or =3 + 3 patients have a similar risk profile as more favourable GS 3 + 4 patients. This finding warrants consideration when deciding on treatment.
Find related publications in this database (using NLM MeSH Indexing): Adult - administration & dosage; Aged - administration & dosage; Biopsy, Needle - administration & dosage; Epidemiologic Methods - administration & dosage; Humans - administration & dosage; Male - administration & dosage; Middle Aged - administration & dosage; Neoplasm Recurrence, Local - pathology; Neoplasm Staging - administration & dosage; Prognosis - administration & dosage; Prostate - pathology, surgery; Prostate-Specific Antigen - metabolism; Prostatectomy - administration & dosage; Prostatic Neoplasms - pathology, surgery
Find related publications in this database (Keywords): prostate cancer; Gleason score; biochemical recurrence; indolent; radical prostatectomy