Oncologic Outcomes of Patients With Gleason Score 7 and Tertiary Gleason Pattern 5 After Radical Prostatectomy.
10.4111/kju.2013.54.9.587
- Author:
Yi Hsueh LENG
1
;
Won Jun LEE
;
Seung Ok YANG
;
Jeong Ki LEE
;
Tae Young JUNG
;
Yun Beom KIM
Author Information
1. Department of Urology, Veterans Health Service Medical Center, Seoul, Korea. uromedi94@gmail.com
- Publication Type:Original Article
- Keywords:
Disease progression;
Neoplasm grading;
Prostatectomy
- MeSH:
Disease Progression;
Humans;
Medical Records;
Neoplasm Grading;
Proportional Hazards Models;
Prostate-Specific Antigen;
Prostatectomy;
Recurrence;
Retrospective Studies;
Tumor Burden
- From:Korean Journal of Urology
2013;54(9):587-592
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated oncologic outcomes following radical prostatectomy (RP) in patients with a Gleason score (GS) of 7 with tertiary Gleason pattern 5 (TGP5). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 310 patients who underwent RP from 2005 to 2010. Twenty-four patients who received neoadjuvant or adjuvant antiandrogen deprivation or radiation therapy were excluded. Just 239 (GS 6 to 8) of the remaining 286 patients were included in the study. Patients were classified into four groups: GS 6, GS 7 without TGP5, GS 7 with TGP5, and GS 8. We analyzed preoperative clinical factors, postoperative pathological outcomes, and biochemical recurrence (BCR). RESULTS: TGP5 in GS 7 was an independent predictor of primary Gleason pattern 4, tumor volume larger than 10%, positive surgical margin, and lymphovascular invasion. The presence of TGP5 in GS 7 was not associated with BCR-free survival. Subgroup analyses revealed that BCR-free survival did not differ significantly between patients with GS 7 with TGP5 and those with GS 8 (p=0.120). In addition, time to BCR in patients with a higher percentage of TGP5 was shorter than that in patients with a lower percentage of TGP5. TGP5 in GS 7 was not a significant predictive factor for BCR, whereas prostate-specific antigen density and a positive surgical margin were shown to be independent predictors of BCR. CONCLUSIONS: TGP5 in GS 7 was an independent predictor of unfavorable pathologic outcomes. The rate of BCR was similar in GS 7 disease with TGP5 and in GS 8 disease, even though TGP5 was not a significant predictive factor for BCR in Cox proportional hazards models.
