scholarly journals Predictive Clinicopathologic Features and Prognostic assessment of pT0 prostate cancer: a case control study

2020 ◽  
Author(s):  
Jiangnan Xu ◽  
Chao Wang ◽  
Jun Ouyang ◽  
Jianglei Zhang ◽  
Zekun Xu
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Clinicopathological Features ◽  
Control Group ◽  
Prognostic Assessment ◽  
Positive Biopsy ◽  
Biopsy Core ◽  
Biopsy Gleason Score

Abstract Background: pT0 prostate cancer is relatively rare. We wanted to share and explore the predictive clinicopathological features and prognosis of biopsy-proven pT0 prostate cancer in Chinese population.Methods: We retrospectively analyzed the clinicopathological and prognostic data of 8 patients with pT0 prostate cancer who received radical prostatectomy (RP) at our institution between 2006 and 2019. pT0 group was compared with a control group of 96 patients who underwent RP during the same period. Exclusion criteria included patients undergoing neoadjuvant hormone therapy or transurethral resection of the prostate (TURP) before the operation．Results: There were significant differences in the exposure rates of six clinicopathological features between two groups. Apart from finasteride use, the other five items were particularly frequent in the pT0 group: prostate-specific antigen (PSA) <10 ng/ml (7/8), one positive biopsy core only (7/8), biopsy Gleason score <7 (8/8), and prostate volume>40ml (7/8), length of biopsy positive for cancer≤2mm. When these five parameters were combined as predictive model, the sensitivity was 75%, the specificity was 99%. The 8 patients were followed up for an average of 67 months without biochemical recurrence or progression.Conclusions: Preoperative PSA, number of positive biopsy core, Gleason score, prostate volume, and the length of cancer can help predict pT0 stage of prostate cancer. Patients with pT0 stage had a relatively favorable prognosis.

scholarly journals Predictors of Gleason score upgrading in patients with prostate biopsy Gleason score ≤6

2014 ◽  
Vol 8 (5-6) ◽  
pp. 342 ◽  
Author(s):  
Hasmet Sarici ◽  
Onur Telli ◽  
Orhan Yigitbasi ◽  
Musa Ekici ◽  
Berat Cem Ozgur ◽  
...  
Keyword(s):  
Gleason Score ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Radical Retropubic Prostatectomy ◽  
Small Sample ◽  
Ultrasound Guided ◽  
Increased Risk ◽  
Biopsy Gleason Score

Introduction: The discrepancy between prostate biopsy and prostatectomy Gleason scores is common. We investigate the predictive value of prostate biopsy features for predicting Gleason score (GS) upgrading in patients with biopsy Gleason scores ≤6 who underwent radical retropubic prostatectomy (RRP). Our aim was to determine predictors of GS upgrading and to offer guidance to clinicians in determining the therapeutic option.Methods: We performed a retrospective study of patients who underwent RRP for clinically localized prostate cancer at 2 major centres between January 2007 and March 2013. All patients with either abnormal digital examination or elevated prostate-specific antigen at screening underwent transrectal ultrasound-guided prostate biopsy. Variables were evaluated among the patients with and without GS upgrading. Our study limitations include its retrospective design, the fact that all subjects were Turkish and the fact that we had a small sample size.Results: In total, 321 men had GS ≤6 on prostate biopsy. Of these, 190 (59.2%) had GS ≤6 concordance and 131 (40.8%) had GS upgrading from ≤6 on biopsy to 7 or higher at the time of the prostatectomy. Independent predictors of pathological upgrading were prostate volume <40 cc (p < 0.001), maximum percent of cancer in any core (p = 0.011), and >1 core positive for cancer (p < 0.001).Conclusions: When obtaining an extended-core biopsy scheme, patients with small prostates (≤40 cc), greater than 1 core positive for cancer, and an increased burden of cancer are associated with increased risk of GS upgrading. Patients with GS ≤6 on biopsy with these pathological parameters should be carefully counselled on treatment decisions.

scholarly journals Clinical and pathological variables that predict changes in tumour grade after radical prostatectomy in patients with prostate cancer

2013 ◽  
Vol 7 (1-2) ◽  
pp. 93 ◽  
Author(s):  
Stavros Sfoungaristos ◽  
Petros Perimenis
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Secondary Analysis ◽  
Intraepithelial Neoplasia ◽  
Treatment Modalities ◽  
Psa Density ◽  
Group 2

Introduction: Preoperative Gleason score is crucial, in combination with other preoperative parameters, in selecting the appropriate treatment for patients with clinically localized prostate cancer. The aim of the present study is to determine the clinical and pathological variables that can predict differences in Gleason score between biopsy and radical prostatectomy.Methods: We retrospectively analyzed the medical records of 302 patients who had a radical prostatectomy between January 2005 and September 2010. The association between grade changes and preoperative Gleason score, age, prostate volume, prostate-specific antigen (PSA), PSA density, number of biopsy cores, presence of prostatitis and high-grade prostatic intraepithelial neoplasia was analyzed. We also conducted a secondary analysis of the factors that influence upgrading in patients with preoperative Gleason score ≤6 (group 1) and downgrading in patients with Gleason score ≤7 (group 2).Results: No difference in Gleason score was noted in 44.3% of patients, while a downgrade was noted in 13.7% and upgrade in 42.1%. About 2/3 of patients with a Gleason score of ≤6 upgraded after radical prostatectomy. PSA density (p = 0.008) and prostate volume (p = 0.032) were significantly correlated with upgrade. No significant predictors were found for patients with Gleason score ≤7 who downgraded postoperatively.Conclusion: Smaller prostate volume and higher values of PSA density are predictors for upgrade in patients with biopsy Gleason score ≤6 and this should be considered when deferred treatment modalities are planned.

Advancing age and the risk of adverse pathology at radical prostatectomy in men with biopsy Gleason score 6 prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 289-289
Author(s):  
Daniel Kim ◽  
Ming-Hui Chen ◽  
Hartwig Huland ◽  
Markus Graefen ◽  
Derya Tilki ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Specific Antigen ◽  
Cancer Center ◽  
Study Cohort ◽  
Pathologic Features ◽  
Younger Men ◽  
Biopsy Gleason Score ◽  
The Impact

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.

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

2016 ◽  
Vol 103 (2) ◽  
pp. 204-208 ◽  
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.

scholarly journals Needle biopsy size and pathological Gleason Score diagnosis: No evidence for a link

2013 ◽  
Vol 7 (9-10) ◽  
pp. 567 ◽  
Author(s):  
Antonio Cicione ◽  
Francesco Cantiello ◽  
Cosimo De Nunzio ◽  
Andrea Tubaro ◽  
Rocco Damiano
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Kappa Statistic ◽  
Study Groups ◽  
Localized Prostate Cancer ◽  
Needle Size ◽  
Biopsy Needle ◽  
Biopsy Gleason Score

Background: Biopsy Gleason score (GS), in combination with other clinical parameters, is important to take a therapeutic decision for patients with diagnosis of localized prostate cancer. However, preoperative GS is often upgraded after a radical prostatectomy. Increasing the amount of tissue in prostate biopsy may be a way to avoid this issue. We evaluate the influence of a larger biopsy needle size on the concordance between biopsy and pathological GS.Methods: We analyzed paired biopsies and prostatectomy specimens from 104 cases of men with clinically localized prostate cancer. At the time of prostate biopsy, the patients were prospectively randomized into two needle groups (16-Gauge [G] and 18G) using a 1:1 ratio. GS concordance was estimated performing kappa statistic testing, overall concordance rate and risk to under grade biopsy GS=6. A logistic regression analysis was performed to evaluate the patients’ characteristics as possible risk factors.Results: The overall concordance between prostate biopsy and pathological GS was 76.9% and 75.6% (p = 0.875) and the k values were 0.821 and 0.811 (p = 0.424), respectively, for 16G and 18G needle study groups. The risk to undergrade a biopsy GS=6 was 21.1% and 15.4% (p = 0.709) using a 16G and 18G needle, respectively. Age, prostate-specific antigen, prostate volume and needle calibre were not independently associated with a higher risk of GS discordance.Conclusions: Needle size does not affect the concordance between biopsy and pathological GS. Although GS is not the only way to determine treatment, it is still an unresolved urological issue.

scholarly journals Fuzzy Expert System for Prediction of Prostate Cancer

2020 ◽  
Vol 16 (01) ◽  
pp. 163-176
Author(s):  
Juthika Mahanta ◽  
Subhasis Panda
Keyword(s):  
Prostate Cancer ◽  
Expert System ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Prostate Cancer Risk ◽  
Fuzzy Expert System ◽  
Knowledge Based ◽  
Free Psa ◽  
Clinical Dataset ◽  
Positive Biopsy

A fuzzy expert system (FES) for the prediction of prostate cancer (PC) is prescribed in this paper. Age, prostate-specific antigen (PSA), prostate volume (PV) and [Formula: see text] Free PSA ([Formula: see text]FPSA) are fed as inputs into the FES and prostate cancer risk (PCR) is obtained as the output. Using knowledge-based rules in Mamdani type inference method the output is calculated. If PCR [Formula: see text], then the patient shall be advised to go for a biopsy test for confirmation. The efficacy of the designed FES is tested against a clinical dataset. The true prediction for all the patients turns out to be [Formula: see text] whereas only for positive biopsy cases it rises to [Formula: see text]. This simple yet effective FES can be used as supportive tool for decision-making in medical diagnosis.

The risk of death from prostate cancer in men with Gleason Score 3+4 prostate cancer treated using brachytherapy with or without a short course of androgen deprivation therapy.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 330-330
Author(s):  
David Dewei Yang ◽  
Ming-Hui Chen ◽  
Michelle H. Braccioforte ◽  
Brian Joseph Moran ◽  
Anthony Victor D'Amico
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Gleason Score ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Risk Of Death ◽  
Short Course ◽  
Increased Risk ◽  
Adenocarcinoma Of The Prostate ◽  
Biopsy Gleason Score

330 Background: We evaluated whether the intermediate-risk factors of percentage of positive biopsies (PPB), clinical tumor category, and prostate-specific antigen (PSA) level, in addition to age, were associated with the risk of prostate cancer-specific mortality (PCSM) among men with Gleason 3+4 prostate cancer treated with brachytherapy (BT) alone or BT and a short course of androgen deprivation therapy (ADT). Methods: We conducted a prospective cohort study of 1920 consecutively treated men with Gleason 3+4 adenocarcinoma of the prostate who received BT or BT and a median of 4 months of ADT between 10/14/1997 and 5/28/2013. Separate multivariable Fine and Gray competing risks regression models among men treated with BT or BT and ADT were used to assess whether PPB, cT2b-T2c, and PSA of 10.1-20.0 ng/ml, in addition to age greater than the median of 70 years, were associated with the risk of PCSM after adjustment for comorbidity. Results: After a median follow-up of 7.8 years (interquartile range 5.2-10.4 years), 284 men (14.8%) had died, including 31 (10.9% of deaths) from PC of which 18 (58.1%) and 13 (41.9%) occurred in men treated with BT or BT and ADT, respectively. For men treated with BT alone, increasing PPB, PSA of 10.1-20.0 vs 4.0-10.0 ng/mL, and age >70 vs ≤70 years were significantly associated with an increased risk of PCSM (adjusted hazard ratio [AHR] 1.015 95% confidence interval [CI] 1.000-1.031, P=0.048; AHR 5.55, 95% CI 2.01-15.29, P<0.001; and AHR 3.66, 95% CI 1.16-11.56, P=0.03, respectively). The respective results for men treated with BT and ADT were AHR 1.009, 95% CI 0.987-1.031, P=0.44; AHR 4.17, 95% CI 1.29-13.50, P=0.02; and AHR 3.74, 95% CI 0.87-16.05, P=0.08. The clinical tumor category was not significantly associated with the risk of PCSM. Conclusions: Among men with biopsy Gleason score 3+4 PC, both age >70 years and PSA of 10.1-20.0 ng/ml were significantly associated with an increased risk of PCSM following BT, and adding 4 months of ADT may not be sufficient to mitigate this risk. Advanced imaging and targeted biopsy of suspicious areas should be considered to personalize treatment in order to minimize the risk of PCSM in these men.

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