Is Biopsy Gleason Score Independently Associated With Biochemical Progression Following Radical Prostatectomy After Adjusting for Pathological Gleason Score?

289 Background: We evaluated the impact of age > 65 years versus younger on the odds of finding adverse pathologic features (pT3/T4 and/or R1 and/or Gleason score 8, 9, 10) at radical prostatectomy (RP) among men with biopsy Gleason score 6 prostate cancer (PC). Methods: The study cohort comprised 3191 men with biopsy Gleason score 6 PC treated with a RP between February 28, 1992 and February 15, 2016 at the Martini-Klinik Prostate Cancer Center. Multivariable logistic regression was used to evaluate the impact of age > 65 years versus younger on the adjusted odds ratio (AOR) of finding adverse pathology at RP adjusting for pre-RP prostate specific antigen (PSA), clinical tumor category, year of diagnosis, percent positive biopsies (PPB), and PSA density (PSAd). Results: Men age > 65 years as compared to younger had significantly lower median PPB (16.67% vs 20.0%; p = 0.01) and PSAd (0.13 ng/mL vs 0.15 ng/mL; p < 0.0001). Yet, while both increasing PPB (AOR 1.018, 95% CI 1.013, 1.023; p- < 0.0001) and PSAd (AOR 4.28, 95% CI 1.66, 11.01; p = 0.003) were significantly associated with an increased odds of finding adverse pathology at RP, men age > 65 years versus younger had a higher odds of adverse pathology at RP (AOR 1.28, 95% CI 1.002, 1.62; p = 0.048). Conclusions: Despite a more favorable median PPB and PSAd, men with biopsy Gleason score 6 PC and who are age > 65 years compared to younger men are at higher risk for having adverse pathology at RP and may benefit from a multiparametric MRI and targeted biopsy before proceeding with active surveillance. If higher grade/stage disease is discovered and treatment indicated then this information could guide both the use and duration of supplemental androgen deprivation therapy in men considering radiation therapy.

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Prognostic Value of Endocan in Prostate Cancer: Clinicopathologic Association between Serum Endocan Levels and Biochemical Recurrence after Radical Prostatectomy

Tumori Journal ◽

10.5301/tj.5000535 ◽

2016 ◽

Vol 103 (2) ◽

pp. 204-208 ◽

Cited By ~ 4

Author(s):

Burak Arslan ◽

Özkan Onuk ◽

İsmet Hazar ◽

Muammer Aydın ◽

Nusret Can Çilesiz ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Gleason Score ◽

Biochemical Recurrence ◽

Specific Antigen ◽

Elevated Serum ◽

Progression Free Survival ◽

Control Group ◽

Free Survival ◽

Biochemical Progression

Purpose To assess the diagnostic capability of serum endocan level in association with clinicopathologic features and its impact on biochemical progression-free survival in patients with prostate cancer (PCa). Methods A total of 86 patients with localized prostate cancer were treated with open radical prostatectomy (RP). The control group included 80 patients who were referred to the urology outpatient clinic with normal rectal examination and prostate-specific antigen (PSA) levels. The patients’ characteristics, baseline PSA value, and serum endocan levels were recorded. The patients were followed up with the measurement of PSA concentration every 3 months during the first year, thereafter every 6 months until 5 years, then yearly after surgery. The primary endpoint of follow-up was the time of biochemical recurrence. Results The median serum endocan levels were 3.14 ng/mL in the RP group and 2.98 ng/mL in the control group (p = 0.122). A total of 86 patients who underwent RP for PCa were divided into 2 groups based on a cutoff serum endocan level of 1.8 ng/mL. The distribution of Gleason score and biochemical failure rate were significantly higher in patients with serum endocan ≥1.8 ng/mL (p = 0.031 and p = 0.047). The biochemical recurrence-free time for endocan ≥1.8 ng/mL and <1.8 ng/mL were 38 and 56 months, respectively (p = 0.041). Spearman correlation analysis showed a linear relationship between endocan expression and Gleason score (p = 0.025, p = 0.511). Multivariate analysis revealed that elevated serum endocan level (≥1.8 ng/mL) was a significant predictor of biochemical progression-free survival (hazard ratio 2.44; 95% confidence interval 1.78-3.23; p = 0.001). Conclusions The current study indicates that endocan has a close relationship with tumor recurrence in PCa.

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526 OUTCOME OF MULTIMODALITY TREATMENT OF HIGH-RISK LOCALIZED PROSTATE CANCER (CT3-4 OR PSA ≥20 NG/ML OR BIOPSY GLEASON SCORE ≥8) WITH RADICAL PROSTATECTOMY AS INITIAL STEP: A MULTI-INSTITUTIONAL OUTCOME STUDY OF 1413 PATIENTS

European Urology Supplements ◽

10.1016/s1569-9056(09)60522-4 ◽

2009 ◽

Vol 8 (4) ◽

pp. 252

Author(s):

S.G. Joniau ◽

M. Spahn ◽

P. Gontero ◽

B. Tombal ◽

C. Bangma ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Gleason Score ◽

Multimodality Treatment ◽

Initial Step ◽

Localized Prostate Cancer ◽

Outcome Study ◽

Biopsy Gleason Score

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Outcome after radical prostatectomy with a pretreatment prostate biopsy Gleason score of ≥8

BJU International ◽

10.1046/j.1464-410x.2003.04419.x ◽

2003 ◽

Vol 92 (6) ◽

pp. 539-544 ◽

Cited By ~ 51

Author(s):

M. Manoharan ◽

V.G. Bird ◽

S.S. Kim ◽

F. Civantos ◽

M.S. Soloway

Keyword(s):

Radical Prostatectomy ◽

Gleason Score ◽

Prostate Biopsy ◽

Biopsy Gleason Score

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845: Gleason Score 6 Prostate Cancer Involving ≤5% of the Needle Biopsy Does Not Predict Biochemical Progression, Final Pathologic Stage, Grade, or Margin Status in Radical Prostatectomy Specimen

The Journal of Urology ◽

10.1016/s0022-5347(18)38094-7 ◽

2004 ◽

Vol 171 (4S) ◽

pp. 223-223

Author(s):

Chandler D. Dora ◽

Thomas J. Sebo ◽

Jeffrey M. Slezak ◽

Erik J. Bergstralh ◽

Michael L. Blute

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Gleason Score ◽

Needle Biopsy ◽

Margin Status ◽

Radical Prostatectomy Specimen ◽

Pathologic Stage ◽

Biochemical Progression ◽

Prostatectomy Specimen

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Influence of Biopsy Gleason Score on the Risk of Lymph Node Invasion in Patients With Intermediate-Risk Prostate Cancer Undergoing Radical Prostatectomy

Frontiers in Surgery ◽

10.3389/fsurg.2021.759070 ◽

2021 ◽

Vol 8 ◽

Author(s):

Mike Wenzel ◽

Felix Preisser ◽

Benedikt Hoeh ◽

Maria N. Welte ◽

Clara Humke ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

High Risk ◽

Radical Prostatectomy ◽

Gleason Score ◽

International Society ◽

Low Risk ◽

Intermediate Risk ◽

Risk Prostate Cancer ◽

Biopsy Gleason Score

Objective: To analyze the influence of biopsy Gleason score on the risk for lymph node invasion (LNI) during pelvic lymph node dissection (PLND) in patients undergoing radical prostatectomy (RP) for intermediate-risk prostate cancer (PCa).Materials and Methods: We retrospectively analyzed 684 patients, who underwent RP between 2014 and June 2020 due to PCa. Univariable and multivariable logistic regression, as well as binary regression tree models were used to assess the risk of positive LNI and evaluate the need of PLND in men with intermediate-risk PCa.Results: Of the 672 eligible patients with RP, 80 (11.9%) men harbored low-risk, 32 (4.8%) intermediate-risk with international society of urologic pathologists grade (ISUP) 1 (IR-ISUP1), 215 (32.0%) intermediate-risk with ISUP 2 (IR-ISUP2), 99 (14.7%) intermediate-risk with ISUP 3 (IR-ISUP3), and 246 (36.6%) high-risk PCa. Proportions of LNI were 0, 3.1, 3.7, 5.1, and 24.0% for low-risk, IR-ISUP1, IR-ISUP 2, IR-ISUP-3, and high-risk PCa, respectively (p < 0.001). In multivariable analyses, after adjustment for patient and surgical characteristics, IR-ISUP1 [hazard ratio (HR) 0.10, p = 0.03], IR-ISUP2 (HR 0.09, p < 0.001), and IR-ISUP3 (HR 0.18, p < 0.001) were independent predictors for lower risk of LNI, compared with men with high-risk PCa disease.Conclusions: The international society of urologic pathologists grade significantly influence the risk of LNI in patients with intermediate- risk PCa. The risk of LNI only exceeds 5% in men with IR-ISUP3 PCa. In consequence, the need for PLND in selected patients with IR-ISUP 1 or IR-ISUP2 PCa should be critically discussed.

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667: Pathological and Biochemical Outcomes after Radical Prostatectomy for Men with a Biopsy Gleason Score of 8 to 10

The Journal of Urology ◽

10.1016/s0022-5347(18)32913-6 ◽

2006 ◽

Vol 175 (4S) ◽

pp. 215-215

Author(s):

Patrick J. Bastian ◽

Mark L. Gonzalgo ◽

Leslie A. Mangold ◽

William J. Aronson ◽

Martha K. Terris ◽

...

Keyword(s):

Radical Prostatectomy ◽

Gleason Score ◽

Biopsy Gleason Score

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Planned nerve preservation modifications to reduce positive surgical margins during robotic-assisted laparoscopic radical prostatectomy

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.15599 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 15599-15599

Author(s):

K. Zorn ◽

O. N. Gofrit ◽

S. Lin ◽

G. D. Steinberg ◽

G. Zagaja ◽

...

Keyword(s):

Radical Prostatectomy ◽

Gleason Score ◽

Clinical Stage ◽

Laparoscopic Radical Prostatectomy ◽

Wide Resection ◽

Control Group ◽

Positive Surgical Margin ◽

Robotic Assisted ◽

Nerve Preservation ◽

Biopsy Gleason Score

15599 Background: Robotic-assisted laparoscopic radical prostatectomy (RLRP) is increasingly being utilized for the treatment of localized prostate cancer at many centers. The main objective of RLRP is cancer control and preservation of erectile function with reduced positive surgical margin (PSM) rates. We evaluated the effect of a side-specific nerve preservation (NP)protocol which was implemented in June 2006 to help further reduce PSM rates. Methods: Between June-November 2006, 150 consecutive RLRPs were performed using select ipsilateral, NP techniques (interfascial, extrafascial and wide resection) based on pre-operative risk factors (clinical stage, biopsy Gleason score (GS), percentage of core number positive and maximal core cancer percentage). Prior to June 2006, only interfascial and wide resection were performed. The NP protocol, included ipsilateral extrafascial dissection in all patients with GS=7 with non-palpable disease. All patients with GS≤6, non-palpable disease and whose biopsy pathology demonstrated <33% of ipsilateral cores positive for cancer were offered interfascial dissection. Wide resection was performed for patients with palpable disease, GS≥8 and ≥66% of all ipsilateral biopsy cores positive for cancer. Pathological outcomes were compared with the 245 consecutive RLRP cases performed prior to June 2006, where more liberal interfascial NP was performed. Results: Relative to the modified NP group, mean patient age (60 vs 59, p= 0.21), PSA (6.7 vs 6.8, p=0.77), clinical stage (p=0.93), biopsy Gleason score (p=0.51), pathologic Gleason score (p=0.32) and stage (p=0.65) were similar to the control group. Mean total number of positive cores involved with cancer were also comparable between groups (3.5 vs 3.3, p=0.31). Overall PSM rate was significantly lower in the modified NP group (12.6% vs 20.4%,p=0.04). Specific pT2-PSM rates were significantly lower (8.3% vs 15%, p=0.04) while only a trend was observed for pT3-PSM rates (34.5% vs 40.4%, p=0.60) in the modified NP group. Conclusions: Modifying ipsilateral nerve preservation for patients undergoing RLRP, based on specific pre-operative variables has significantly helped further reduce overall and pT2-specific PSM rates. No significant financial relationships to disclose.

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