scholarly journals Gleason Score 7 Prostate Cancers Emerge through Branched Evolution of Clonal Gleason Pattern 3 and 4

2017 ◽  
Vol 23 (14) ◽  
pp. 3823-3833 ◽  
Author(s):  
Adam G. Sowalsky ◽  
Haydn T. Kissick ◽  
Sean J. Gerrin ◽  
Rachel J. Schaefer ◽  
Zheng Xia ◽  
...  
Keyword(s):  
Gleason Score ◽  
Gleason Pattern ◽  
Prostate Cancers ◽  
Branched Evolution

PREDICTION OF GLEASON SCORE UPGRADING IN LOW RISK PROSTATE CANCERS DIAGNOSED VIA MULTI (≥ 12)-CORE PROSTATE BIOPSY

2009 ◽  
Vol 181 (4) ◽  
pp. 713
Author(s):  
Sung Kyu Hong ◽  
Seung Tae Lee ◽  
Byung Kyu Han ◽  
Myung Kim ◽  
Sung-Soo Kim ◽  
...  
Keyword(s):  
Gleason Score ◽  
Prostate Biopsy ◽  
Low Risk ◽  
Prostate Cancers

scholarly journals Gleason Score and Lethal Prostate Cancer: Does 3 + 4 = 4 + 3?

2009 ◽  
Vol 27 (21) ◽  
pp. 3459-3464 ◽  
Author(s):  
Jennifer R. Stark ◽  
Sven Perner ◽  
Meir J. Stampfer ◽  
Jennifer A. Sinnott ◽  
Stephen Finn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Predictive Ability ◽  
Fold Increase ◽  
Health Study ◽  
Prognostic Information ◽  
Gleason Grading ◽  
Gleason Pattern ◽  
C Statistic ◽  
Bony Metastases

Purpose Gleason grading is an important predictor of prostate cancer (PCa) outcomes. Studies using surrogate PCa end points suggest outcomes for Gleason score (GS) 7 cancers vary according to the predominance of pattern 4. These studies have influenced clinical practice, but it is unclear if rates of PCa mortality differ for 3 + 4 and 4 + 3 tumors. Using PCa mortality as the primary end point, we compared outcomes in Gleason 3 + 4 and 4 + 3 cancers, and the predictive ability of GS from a standardized review versus original scoring. Patients and Methods Three study pathologists conducted a blinded standardized review of 693 prostatectomy and 119 biopsy specimens to assign primary and secondary Gleason patterns. Tumor specimens were from PCa patients diagnosed between 1984 and 2004 from the Physicians' Health Study and Health Professionals Follow-Up Study. Lethal PCa (n = 53) was defined as development of bony metastases or PCa death. Hazard ratios (HR) were estimated according to original GS and standardized GS. We compared the discrimination of standardized and original grading with C-statistics from models of 10-year survival. Results For prostatectomy specimens, 4 + 3 cancers were associated with a three-fold increase in lethal PCa compared with 3 + 4 cancers (95% CI, 1.1 to 8.6). The discrimination of models of standardized scores from prostatectomy (C-statistic, 0.86) and biopsy (C-statistic, 0.85) were improved compared to models of original scores (prostatectomy C-statistic, 0.82; biopsy C-statistic, 0.72). Conclusion Ignoring the predominance of Gleason pattern 4 in GS 7 cancers may conceal important prognostic information. A standardized review of GS can improve prediction of PCa survival.

scholarly journals Comparing Prostate Imaging-Reporting and Data System Version 2 (PI-RADSv2) Category 1 and 2 Groups: Clinical Implication of Negative Multiparametric Magnetic Resonance Imaging

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jung Kwon Kim ◽  
Hak Jong Lee ◽  
Sung Il Hwang ◽  
Gheeyoung Choe ◽  
Sung Kyu Hong
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Gleason Score ◽  
Univariate Analysis ◽  
Data System ◽  
Resonance Imaging ◽  
Fusion Biopsy ◽  
Prostate Imaging ◽  
Gleason Pattern ◽  
Clinical Databases

Objectives. To evaluate the clinicopathological differences between Prostate Imaging-Reporting and Data System (PI-RADS) version 2 (v2) category 1 and 2 groups. Materials and Methods. We retrospectively reviewed our two institutional clinical databases: (1) transrectal ultrasound (TRUS)/magnetic resonance imaging (MRI) fusion biopsy cohort (n=706) and (2) radical prostatectomy (RP) cohort (n=1403). Subsequently, we performed comparative analyses between PI-RADSv2 category 1 and 2 groups. Clinically significant prostate cancer (csPCa) was defined as the presence of Gleason score GS≥3+4 in a single biopsy core, and adverse pathology (AP) was defined as high-grade (primary Gleason pattern 4 or any pattern 5) and/or non-organ-confined disease (pT3/N1). We also performed multivariate logistic regression analyses for AP. Results. In the TRUS/MRI fusion biopsy cohort, no significant differences in detection rates of all cancer (18.2% vs. 29.0%, respectively, P=0.730) or csPCa (9.1% vs. 9.9%, respectively, P=0.692) were observed between PI-RADSv2 category 1 and 2 groups. There were no significant differences in pathologic outcomes including Gleason score (≥4+3, 21.2% vs. 29.9%, respectively, P=0.420) or detection rate of AP (27.3% vs. 33.8%, respectively, P=0.561) between the two groups in the RP cohort either. PI-RADSv2 category 1 or 2 had no significant association with AP, even in univariate analysis (P=0.299). Conclusions. PI-RADSv2 categories 1 and 2 had similar performance to predict clinicopathological outcomes. Consequently, these two categories may be unified into a single category. Negative mpMRI does not guarantee the absence of AP, as with csPCa.

scholarly journals Essential Updates in Grading, Morphotyping, Reporting, and Staging of Prostate Carcinoma for General Surgical Pathologists

2019 ◽  
Vol 143 (5) ◽  
pp. 550-564 ◽  
Author(s):  
Gladell P. Paner ◽  
Jatin Gandhi ◽  
Bonnie Choy ◽  
Mahul B. Amin
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Gleason Score ◽  
Prostate Carcinoma ◽  
Multidisciplinary Care ◽  
Tnm Staging ◽  
International Consensus ◽  
Gleason Pattern ◽  
Consensus Conferences ◽  
Worse Prognosis

Context.— Within this decade, several important updates in prostate cancer have been presented through expert international consensus conferences and influential publications of tumor classification and staging. Objective.— To present key updates in prostate carcinoma. Data Sources.— The study comprised a review of literature and our experience from routine and consultation practices. Conclusions.— Grade groups, a compression of the Gleason system into clinically meaningful groups relevant in this era of active surveillance and multidisciplinary care management for prostate cancer, have been introduced. Refinements in the Gleason patterns notably result in the contemporarily defined Gleason score 6 cancers having a virtually indolent behavior. Grading of tertiary and minor higher-grade patterns in radical prostatectomy has been clarified. A new classification for prostatic neuroendocrine tumors has been promulgated, and intraductal, microcystic, and pleomorphic giant cell carcinomas have been officially recognized. Reporting the percentage of Gleason pattern 4 in Gleason score 7 cancers has been recommended, and data on the enhanced risk for worse prognosis of cribriform pattern are emerging. In reporting biopsies for active surveillance criteria–based protocols, we outline approaches in special situations, including variances in sampling or submission. The 8th American Joint Commission on Cancer TNM staging for prostate cancer has eliminated pT2 subcategorization and stresses the importance of nonanatomic factors in stage groupings and outcome prediction. As the clinical and pathology practices for prostate cancer continue to evolve, it is of utmost importance that surgical pathologists become fully aware of the new changes and challenges that impact their evaluation of prostatic specimens.

Primary Gleason pattern does not impact survival after permanent interstitial brachytherapy for Gleason score 7 prostate cancer

Cancer ◽  
2007 ◽  
Vol 110 (2) ◽  
pp. 289-296 ◽  
Author(s):  
Gregory S. Merrick ◽  
Robert W. Galbreath ◽  
Wayne M. Butler ◽  
Kent E. Waller ◽  
Zachariah A. Allen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Interstitial Brachytherapy ◽  
Gleason Pattern

Significance of tertiary pattern 5 in patients with gleason score 7 after radical prostatectomy.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 117-117
Author(s):  
Jiakun Li ◽  
Yaochuan Guo ◽  
Shi Qiu ◽  
Mingjing He ◽  
Kun Jin ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Gleason Score ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Statistical Significance ◽  
Strong Association ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Gleason Pattern ◽  
Cox Proportional Hazards Models

117 Background: To evaluate the association between tertiary Gleason pattern (TGP) 5 and the biochemical recurrence (BCR) in patients with prostate cancer (PCa) of Gleason score (GS) 7 after radical prostatectomy(RP). Methods: This retrospective study collected 387 patients received RP and diagnosed GS 7 (3+4 or 4+3) in the West China Hospital from January 2009 to December 2017.Regardlessly the first Gleason pattern, patients were divide into 2 groups: TGP5 absence and TGP5 presence. Furthermore, we added the primary Gleason pattern to divided patients into 4 groups: GS 3+4, GS 3+4/TGP 5, Gleason 4+3, Gleason 4+3/TGP 5. Cox proportional-hazards models was used to evaluate the association between the status of TGP5 and BCR after adjusting the confounding factors with follow-up time as the underlying time scale. All the analyses were conducted with the use of statistical software packages Rnand EmpowerStats and conducted as two sides and P values less than 0.05 were considered statistical significance. Results: In the results by using Cox proportional-hazards model, regardless the primary Gleason pattern, comparing TGP5 absence (89.7%) and presence (10.3%), the risk of BCR for patients with tertiary Gleason pattern 5 presence was statistically significantly higher than absence (P = 0.02, HR = 2.24, 95%Cl: 1.12-4.49). In terms of the patients with primary Gleason pattern 4, the risk of BCR for patients with Gleason 4+3/TGP5 was statistically significantly higher than Gleason 4+3.(P = 0.02, HR = 2.56, 95%Cl: 1.16-5.67). There was a marked trend that patients with Gleason 3+4/TGP 5 has a higher risk of BCR compared with patients with Gleason 3+4, although there was no statistical difference (P = 0.58, HR = 1.82, 95%Cl: 0.22-14.96). Conclusions: The TGP5 in patients with GS 7 had strong association with the risk of BCR and it was an independent predictor for BCR. This result was more obvious in patients with GS 7 (4+3) in our study. Further researches with larger data size were needed to confirm these funding.

Sign in / Sign up

Export Citation Format

Share Document