MP79-12 KI-67 PROLIFERATION ON PROSTATE BIOPSY IS ASSOCIATED WITH UNFAVORABLE PATHOLOGY AT PROSTATECTOMY AND BIOCHEMICAL RECURRENCE AMONG LOW RISK PROSTATE CANCER

1 Background: To determine whether the efficacy of a hypofractionated (H) schedule is no worse than a conventional (C) schedule in men with low-risk prostate cancer. Methods: From April 2006 to December 2009, one thousand one hundred fifteen men with low-risk prostate cancer (clinical stage T1-2a, Gleason ≤ 6, PSA < 10) were randomly assigned 1:1 to a conventional (C) schedule (73.8 Gy in 41 fractions over 8.2 weeks) or to a hypofractionated (H) schedule (70 Gy in 28 fractions over 5.6 weeks). The trial was designed to establish with 90% power and alpha = 0.05 that (H) results in 5-year disease-free survival (DFS) that is not lower than (C) by more than 7% (hazard ratio (HR) < 1.52). Secondary endpoints include freedom from biochemical recurrence (FFBR) and overall survival. At the third planned interim analysis (July 2015), the NRG Oncology Data Monitoring Committee recommended that the results of the trial be reported. Results: One thousand one hundred and one protocol eligible men were randomized: 547 to C and 554 to H. Median follow-up is 5.9 years. Baseline characteristics are not different according to treatment arm. At the time of analysis 185 DFS events have been observed; 99 in the C arm and 86 in the H arm. The estimated 7-year disease-free survival is 75.6% (95% CI 70.3, 80.1) in the C arm and 81.8% (77.5, 85.3) in the H arm. The DFS HR (C/H) is 0.85 (0.64, 1.14). Comparison of biochemical recurrence (HR = 0.77, (0.51, 1.17)) and overall survival (HR = 0.95, (0.65, 1.41)) also met protocol non-inferiority criteria. Grade ≥ 3 GI toxicity is 3.0% (C) vs. 4.6% (H), Relative risk (RR) for H vs. C 1.53, (95% CI 0.86, 2.83); grade ≥ 3 GU toxicity is 4.5% (C) vs. 6.4% (H), RR = 1.43 (0.86,2.37). Conclusions: In men with low-risk prostate cancer, 70 Gy in 28 fractions over 5.6 weeks is non-inferior to 73.8 Gy in 41 fractions over 8.2 weeks. Clinical trial information: NCT00331773.

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Re: More Favorable Pathological Outcomes in Men with Low Risk Prostate Cancer Diagnosed on Repeat Versus Initial Transrectal Ultrasound Guided Prostate Biopsy

European Urology ◽

10.1016/j.eururo.2016.07.038 ◽

2016 ◽

Vol 70 (4) ◽

pp. 702-703

Author(s):

Alexander Govorov

Keyword(s):

Prostate Cancer ◽

Prostate Biopsy ◽

Transrectal Ultrasound ◽

Low Risk ◽

Ultrasound Guided ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer

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1483 CORE LENGTH AS A PREDICTOR OF GLEASON SCORE UPGRADING IN MEN DIAGNOSED WITH LOW RISK PROSTATE CANCER BY CONTEMPORARY MULTICORE PROSTATE BIOPSY

The Journal of Urology ◽

10.1016/j.juro.2013.02.2948 ◽

2013 ◽

Vol 189 (4S) ◽

Cited By ~ 1

Author(s):

Sangchul Lee ◽

Jung Keun Lee ◽

Chang Wook Jeong ◽

Seong Jin Jeong ◽

Sung Kyu Hong ◽

...

Keyword(s):

Prostate Cancer ◽

Gleason Score ◽

Prostate Biopsy ◽

Low Risk ◽

Core Length ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer

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The Comparison of ISUP Grades Between Prostate Biopsy and Radical Prostatectomy: The Incoherence and Related Factors

Acta Medica ◽

10.32552/2021.actamedica.580 ◽

2021 ◽

Vol 52 (3) ◽

pp. 213-218

Author(s):

Erman Ceyhan ◽

Burak Yılmaz ◽

Bülent Öztürk

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

International Society ◽

Prostate Biopsy ◽

Low Risk ◽

Related Factors ◽

Number Of Patients ◽

Significant Difference ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer

Objective: To assess the incoherence rates between prostate biopsies and radical prostatectomy specimens with the use of the International Society of Urological Pathology grading system and to identify the related factors. Materials and Methods: 89 radical prostatectomy patients were analyzed retrospectively. Patients with Gleason score≥6 were included to the study. Patients’ prostate spesific antigen levels, digital rectal examination, prostate biopsy parameters, prostate cancer risk groups and final prostatectomy pathologies were examined. Gleason scores and International Society of Urological Pathology grades of prostate biopsy and prostatectomy specimens were compared. The coherence, upgrading and downgrading rates of pathologies assessed and related factors were identified. Results: Patients’ mean age was 63.1±6.0 years. Prostate spesific antigen levels ranged from 2.8 to 114.0ng/mL(mean:14.8±16.7). The mean number of cores biopsied was 10.9±3.1. Number of patients in low, intermediate and high risk group were 27(30.3%), 34(38.2%) and 28(31.5%) respectively. The coherence, upgrading and downgrading rates according to International Society of Urological Pathology grading were 49.4%, 33.7% and 16.9% respectively. The low risk prostate cancer group showed the most coherent pathologies with the rate of 70.4%(p<0.05, both for International Society of Urological Pathology grading and Gleason scoring). There was no significant relation between prostate spesific antigen level, number of cores biopsied, percentage of cancer involvement, presence of perineural invasion coherence, upgrading and downgrading. Also no significant difference found between coherent, upgrading and downgrading pathologies with respect to the time to radical prostatectomy. Conclusion: The incoherence between prostate biopsy and radical prostatectomy is challenging. Risk of upgrading and downgrading should be considered in decision making. Low risk prostate cancer shows the most coherent pathology between prostate biopsy and radical prostatectomy.

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