Impact of tertiary Gleason pattern 5 on prostate cancer aggressiveness: Lessons from a contemporary single institution radical prostatectomy series

15 Background: This retrospective study was conducted to better evaluate the impact of tertiary Gleason pattern 5 (TP5) on tumor pathological features and biochemical recurrence following radical prostatectomy (RP). Methods: We retrospectively reviewed 1,965 patients who underwent RP for clinically localized prostate cancer; TP5 was reported in 159 cases (8.1%). Men with Gleason score (GS) 7 and GS 8 disease were divided into two subgroups, with and without TP5, and histopathologic features were compared. Multivariate analyses and Kaplan-Meier curves were conducted to assess the impact on TP5 on biochemical-free survival (BFS). Results: Tumors possessing GS 3 + 4 with TP5 were significantly more likely to exhibit extraprostatic extension (EPE) and have a larger tumor diameter (TD) than GS 3 + 4 alone. GS 3 + 4 with TP5 was also associated with positive surgical margins (SM), seminal vesicle involvement (SVI), and higher pre-operative PSA values, but without statistical significance. GS 4 + 3 with TP5 more commonly presented with EPE, positive SM, SVI, and greater TD and PSA than GS 4 + 3 alone, with significance. In multivariate analysis, TP5 was shown to be an independent risk factor for PSA recurrence (Table). Additionally, GS 4 + 3 with TP5 was associated with shorter time to recurrence versus GS 4 + 3 alone. Conclusions: Our results emphasize the importance of high-grade tertiary patterns and suggest that criteria for tertiary pattern reporting in prostate cancer should be standardized. In addition, further studies are needed to evaluate the role of tertiary patterns in prognostic models. [Table: see text]

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Translationally Controlled Tumor Protein in Prostatic Adenocarcinoma: Correlation with Tumor Grading and Treatment-Related Changes

BioMed Research International ◽

10.1155/2015/985950 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Bruno Jim Rocca ◽

Alessandro Ginori ◽

Aurora Barone ◽

Calogera Calandra ◽

Filippo Crivelli ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Neoadjuvant Treatment ◽

Peripheral Zone ◽

Response To Treatment ◽

Castration Resistance ◽

Translationally Controlled Tumor Protein ◽

Combined Androgen Blockade ◽

Gleason Pattern ◽

Cancer Aggressiveness

Prostate cancer is the second leading cause of cancer-related death. The androgen deprivation therapy is the standard treatment for advanced stages. Unfortunately, virtually all tumors become resistant to androgen withdrawal. The progression to castration-resistance is not fully understood, although a recent paper has suggested translationally controlled tumor protein to be implicated in the process. The present study was designed to investigate the role of this protein in prostate cancer, focusing on the correlation between its expression level with tumor differentiation and response to treatment. We retrieved 292 prostatic cancer specimens; of these 153 had been treated only by radical prostatectomy and 139 had undergone radical prostatectomy after neoadjuvant treatment with combined androgen blockade therapy. Non-neoplastic controls were represented by 102 prostatic peripheral zone specimens. In untreated patients, the expression of the protein, evaluated by RT-qPCR and immunohistochemistry, was significantly higher in tumor specimens than in non-neoplastic control, increasing as Gleason pattern and score progressed. In treated prostates, the staining was correlated with the response to treatment. An association between protein expression and the main clinicopathological factors involved in prostate cancer aggressiveness was identified. These findings suggest that the protein may be a promising prognostic factor and a target for therapy.

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