Low-Risk Prostate Cancer and Tumor Upgrading to Higher Patterns in the Surgical Specimen. Analysis of Clinical Factors Predicting Tumor Upgrading to Higher Gleason Patterns in a Contemporary Series of Patients Who Have Been Evaluated According to the Modified Gleason Score Grading System

2016 ◽  
Vol 97 (1) ◽  
pp. 32-41 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Salvatore Siracusano ◽  
Nicolò De Luyk ◽  
Paolo Corsi ◽  
Marco Sebben ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Low Risk ◽  
Grading System ◽  
Clinical Factors ◽  
Surgical Specimen ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

Clinical factors stratifying the risk of tumor upgrading to high-grade disease in low-risk prostate cancer

2018 ◽  
Vol 104 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Antonio B. Porcaro ◽  
Salvatore Siracusano ◽  
Nicolò de Luyk ◽  
Paolo Corsi ◽  
Marco Sebben ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Specific Antigen ◽  
Low Risk ◽  
Grading System ◽  
High Grade ◽  
Clinical Factors ◽  
Tumor Grading ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

Purpose: To identify clinical factors stratifying the risk of tumor upgrading to increasing patterns of the tumor grading system in low-risk prostate cancer (PCa). Methods: We evaluated the records of 438 patients who underwent radical prostatectomy. Associations between clinical factors and tumor upgrading were assessed by the univariate and multivariate multinomial logistic regression model. Results: Low-risk PCa included 170 cases (38.8%) and tumor upgrading was detected in 111 patients (65.3%): 72 (42.4%) had pathology Gleason pattern (pGP) 3 + 4, 27 (15.9%) pGP 4 + 3, and 12 (7.1%) pGP 4 + 4. Prostate- specific antigen (PSA) and proportion of positive cores (P+) were independent predictors of upgrading to high-risk disease. These factors also stratified the risk of tumor upgrading to the increasing patterns of the tumor grading system. The model allowed the identification of pGP 4 + 4. The main difference between high-risk PCa and other upgraded tumors related to PSA load (odds ratio 2.4) that associated with high volume disease in the specimen. Conclusions: Low-risk PCa is a heterogeneous population with significant rates of tumor upgrading. Significant clinical predictors stratifying the risk of tumor upgrading to increasing patterns of the grading system included PSA and P+. These factors allowed the identification of the subset hiding high-grade disease requiring further investigations before delivering active treatments.

Neutrophil, Platelets, and Eosinophil to Lymphocyte Ratios Predict Gleason Score Upgrading in Low-Risk Prostate Cancer Patients

2018 ◽  
Vol 102 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Matteo Ferro ◽  
Gennaro Musi ◽  
Alessandro Serino ◽  
Gabriele Cozzi ◽  
Francesco Alessandro Mistretta ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Gleason Score ◽  
Low Risk ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

Multiparametric prostate MRI and MRI/ultrasound fusion biopsy as tools to follow prostate cancer progression for men on active surveillance.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 63-63 ◽  
Author(s):  
Nabeel Shakir ◽  
Annerleim Walton-Diaz ◽  
Soroush Rais-Bahrami ◽  
Baris Turkbey ◽  
Jason Rothwax ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Gleason Score ◽  
Cancer Progression ◽  
Predictive Value ◽  
Low Risk ◽  
Fusion Biopsy ◽  
Trus Biopsy ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

63 Background: Active surveillance (AS) is an option for patients with low risk prostate cancer (PCa); however, determining disease progression is challenging. At the NCI, multiparametric MRI (MP-MRI) with our biopsy protocol (MR-US fusion-guided plus 12 core extended sextant biopsy) has been used to confirm eligibility for AS. We evaluated the utility of these modalities in monitoring patients on AS. Methods: Patients who underwent MP-MRI of the prostate with biopsy per our protocol between 2007-2012 were reviewed. We selected a subset who met Johns Hopkins criteria for AS (Gleason score≤6, PSA density≤0.15, tumor involvement of ≤2 cores, and ≤50% of any single core) by outside 12−core TRUS biopsy. Patients with Gleason score≤6 confirmed at first NCI biopsy session were followed with annual MP-MRI and biopsy. MRI progression was defined as an increase in MP-MRI suspicion level, lesion diameter, or number of lesions. Pathologic progression was defined as an increase to Gleason score≥7 in either 12-core or MR-fusion biopsy. We determined the association between MRI and pathologic progression. Results: 129 patients met JHU criteria for AS by outside biopsy. Mean age was 61.6 years and mean PSA 5.16ng/mL. 28/129 (21.7%) patients had Gleason score ≥7 at first NCI biopsy session.31 patients had at least two biopsy sessions (mean follow up 18 months, range 12-54 months) of which 9/31 (29%) increased in Gleason score, all to 3+4=7. Fusion biopsy detected more pathologic progression than did standard biopsy (Table). The positive predictive value of MP-MRI for pathologic progression was 50%, while the negative predictive value was 84%. The sensitivity and specificity of MP-MRI for increase in Gleason score was 67% and 73%, respectively. Conclusions: Stable findings on MP-MRI are associated with Gleason score stability in patients with low-risk PCa choosing AS. The majority of patients who had pathologic progression were detected on fusion biopsy, which may suggest that random biopsies are unnecessary in this population. Larger studies are needed to validate these findings. [Table: see text]

Prostate Size as a Predictor of Gleason Score Upgrading in Patients With Low Risk Prostate Cancer

2011 ◽  
Vol 186 (6) ◽  
pp. 2221-2227 ◽  
Author(s):  
Judson D. Davies ◽  
Monty A. Aghazadeh ◽  
Sharon Phillips ◽  
Shady Salem ◽  
Sam S. Chang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Low Risk ◽  
Prostate Size ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

OLDER AGE AND TIME TO LAST BIOPSY ARE ASSOCIATED WITH RISE IN GLEASON SCORE FOR MEN ON ACTIVE SURVEILLANCE FOR LOW RISK PROSTATE CANCER

2008 ◽  
Vol 179 (4S) ◽  
pp. 154-154 ◽  
Author(s):  
Marc A Dall'Era ◽  
Badrinath R Konety ◽  
Maxwell V Meng ◽  
Katsuto Shinohara ◽  
Nannette Perez ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Gleason Score ◽  
Older Age ◽  
Low Risk ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

scholarly journals Predicting Low-Risk Prostate Cancer from Transperineal Saturation Biopsies

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Pim J. van Leeuwen ◽  
Amila Siriwardana ◽  
Monique Roobol ◽  
Francis Ting ◽  
Daan Nieboer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Tumour Volume ◽  
Low Risk ◽  
Gleason Grade ◽  
Saturation Biopsy ◽  
Core Length ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer ◽  
Total Tumour Volume

Introduction. To assess the performance of five previously described clinicopathological definitions of low-risk prostate cancer (PC).Materials and Methods. Men who underwent radical prostatectomy (RP) for clinical stage ≤T2, PSA <10 ng/mL, Gleason score <8 PC, diagnosed by transperineal template-guided saturation biopsy were included. The performance of five previously described criteria (i.e., criteria 1–5, criterion 1 stringent (Gleason score 6 + ≤5 mm total max core length PC + ≤3 mm max per core length PC) up to criterion 5 less stringent (Gleason score 6-7 with ≤5% Gleason grade 4) was analysed to assess ability of each to predict insignificant disease in RP specimens (defined as Gleason score ≤6 and total tumour volume <2.5 mL, or Gleason score 7 with ≤5% grade 4 and total tumour volume <0.7 mL).Results. 994 men who underwent RP were included. Criterion 4 (Gleason score 6) performed best with area under the curve of receiver operating characteristics 0.792. At decision curve analysis, criterion 4 was deemed clinically the best performing transperineal saturation biopsy-based definition for low-risk PC.Conclusions. Gleason score 6 disease demonstrated a superior trade-off between sensitivity and specificity for clarifying low-risk PC that can guide treatment and be used as reference test in diagnostic studies.

scholarly journals Endogenous testosterone density as ratio of endogenous testosterone levels on prostate volume predicts tumor upgrading in low-risk prostate cancer

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Sebastian Gallina ◽  
Alberto Bianchi ◽  
Clara Cerrato ◽  
Alessandro Tafuri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Low Risk ◽  
Surgical Specimen ◽  
Prostate Specific Antigen Density ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer ◽  
Tumor Load ◽  
Risk Patients

Abstract Objectives To evaluate preoperative endogenous testosterone (ET) density (ETD), defined as the ratio of ET on prostate volume, and tumor upgrading risk in low-risk prostate cancer (PCa). Materials and methods From November 2014 to December 2019, 172 low-risk patients had ET (nmol/L) measured. ETD, prostate-specific antigen density (PSAD) and the ratio of percentage of biopsy positive cores (BPC) to prostate volume (PV), defined as BPC density (BPCD), were evaluated. Associations with tumor upgrading in the surgical specimen were assessed by statistical methods. Results Overall, 121 patients (70.3%) had tumor upgrading, which was predicted by BPCD (odds ratio, OR = 4.640; 95% CI 1.903–11.316; p = 0.001; overall accuracy: 70.3%). On multivariate analysis, tumor upgrading and clinical density factors related to each other for BPCD being predicted by ETD (regression coefficient, b = 0.032; 95% CI 0.021–0.043; p < 0.0001), PSAD (b = 1.962; 95% CI 1.067–2.586; p < 0.0001) and tumor upgrading (b = 0.259; 95% CI 0.112–0.406; p = 0.001). According to the model, as BPCD increased, ETD and PSAD increased, but the increase was higher for upgraded cases who showed either higher tumor load but significantly lower mean levels of either ET or PSA. Conclusions As ETD increased, higher tumor loads were assessed; however, in upgraded patients, lower ET was also detected. ETD might stratify low-risk disease for tumor upgrading features.

Sign in / Sign up

Export Citation Format

Share Document