Factors Predicting Prostatic Biopsy Gleason Sum Under Grading

Stackhouse, Danielle A.; Sun, Leon; Schroeck, Florian R.; Jayachandran, Jayakrishnan; Caire, Arthur; Acholo, Cyril O.; Robertson, Cary N.; Albala, David; Polascik, Thomas J.; Donatucci, Craig F.; Maloney, Kelly E.; Moul, Judd W.

doi:10.1016/j.juro.2009.02.127

Cited by 20 publications

(16 citation statements)

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“…17,21 Although the appropriate number of cores that should be obtained during a prostate biopsy has not clarified, most studies contend that 10 or more biopsy cores increase the likelihood of correct GS prediction. 19,[22][23][24] However, this was not the case in our study. No association was found between the number of cores and tumour grade prediction.…”

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confidence: 74%

“…The association between smaller prostate volume and upgrading of the GS has been reported. 7,16,17,19 It was found that prostate volume of ≤20 mL have a higher risk for upgrade than prostate volume of >60 mL. 20 On the other hand, no correlation was found in another study when one or more histopathologic grades on needle biopsy and subsequent RP specimens were compared with prostate volume.…”

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

Sfoungaristos

Perimenis

2013

CUAJ

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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. Methods We retrospectively reviewed the medical records of 302 patients with clinically localized prostate cancer. A retro-pubic RP was performed in all patients between January 2005 and September 2010. Preoperative therapy for pros-tate cancer (active surveillance, hormone therapy, radiation therapy) was an exclusion criterion, as PSA and GS needed to be clear of any influences. Patients with incomplete medical records were also excluded. Patients who had previ-Positive 42 (75.0) 14 (25.0) Negative 49 (76.6) 15 (23.4) HGPIN, n (%) 0.335 § Positive 44 (72.1) 17 (27.9) Negative 47 (79.7) 12 (20.3) *statistical significance; †Student's t test; ‡Mann-Whitney U test; § Chi-square χ2 test; SD: standard deviation; IQR: interquartile range; GS: Gleason score; HGPIN: high-grade prostatic intraepithelial neoplasia; PSA: prostate-specific antigen.

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

Sfoungaristos

Perimenis

2013

CUAJ

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“…Numerous studies have attempted to characterize the risk of GSU [10,11,12]. However, few studies have focused on the role of a delay between the time of biopsy and the time of surgery.…”

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confidence: 99%

Does the Time From Biopsy to Radical Prostatectomy Affect Gleason Score Upgrading in Patients With Clinical T1c Prostate Cancer?

et al. 2014

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PurposeIt is debated whether treatment delay worsens oncologic results in localized prostate cancer (PCa). Few studies have focused on the role of a delay between the time of biopsy and the time of surgery. Thus, we aimed to investigate the effect of the time period between biopsy and surgery on Gleason score upgrading (GSU).Materials and MethodsA total of 290 patients who underwent radical retropubic prostatectomy in Ankara Training and Research Hospital were included in the study. The biopsy Gleason score, age, total prostate-specific antigen (PSA) value, prostate volumes, and PSA density (PSAD) were analyzed in all patients. The patients were divided into two groups: patients with GSU (group 1) and patients without GSU (group 2). Variables having a p-value of ≤0.05 in the univariate analysis were selected and then evaluated by use of multivariate logistic regression models. Results were considered significant at p<0.05.ResultsGSU occurred in 121 of 290 patients (41.7%). The mean age of the patients was 66.0±7.2 years in group 1 and 65.05±5.60 years in group 2 (p=0.18). The mean PSA values of groups 1 and 2 were 8.6±4.1 and 8.8±4.3 ng/dL, respectively. The mean prostate volumes of groups 1 and 2 were 43.8±14.1 and 59.5±29.8 mL, respectively. The PSAD of group 1 was significantly higher than that of group 2 (0.20 vs. 0.17, p=0.003). The mean time to surgery was shorter in group 2 (group 1, 52.2±22.6 days; group 2, 45.3±15.5 days; p=0.004). According to the logistic regression, time from biopsy to surgery is important in the prediction of GSU.ConclusionsWe suggest that the time period between biopsy and surgery is a significant factor that affects GSU in patients with clinically localized PCa.

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“…Stackhouse et al conducted a nomogram by using age, PSA, prostate volume, biopsy Gleason sum, ratio of positive biopsy core and maximum percentage of cancer in cores. The accuracy of nomogram was 72.4% [33]. Capitonio et al developed their nomograms by using PSA, clinical stage, primary and secondary Gleason score in biopsy.…”

Section: Nomograms To Predict the Gleason Scorementioning

confidence: 99%

Nomograms as Predictive Tools for Prostate Cancer Patients Who Had Radical Prostatectomy

Eskiçorapçı¹,

Acar²,

Sınık³

et al. 2011

OJU

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Prostate cancer is the most common solid cancer for men in the developed countries. Radical prostatectomy is the most preferred treatment modality for localized prostate cancer. Individual decision making is necessary for each patient because of the diversities in the biological characteristics of the prostate cancer. The prediction of pathologic stage, prognosis and cancer specific mortality after curative therapy and quality of life issues are essential for counseling and tailoring treatment in possible candidates of radical prostatectomy. Several studies demonstrated that nomograms are the best predictive tools regarding the other prediction models. For better understanding the nomograms in radical prostatectomy patients, they should be classified according to categories for their use. PSA, Gleason grade and clinical stage are seemed to be the most important prognostic factors in patients who are candidates for radical prostatectomy. Additionally, the pathological parameters are remarkable prognostic criteria. The Partin tables for predicting the radical prostatectomy pathology and Kattan nomograms for predicting the biochemical recurrences free survival rates are the most frequently used nomograms. Today, these nomograms should not replace the clinical decisions but they give significant information for the patients' prognosis, treatment selection and follow up.

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Factors Predicting Prostatic Biopsy Gleason Sum Under Grading

Abstract: The risk of Gleason sum under grading can be predicted to a satisfactory level using our nomogram. Predicting under grading would improve patient consulting and identify those who should consider repeat biopsy, ultimately enhancing the accuracy of prostate cancer diagnosis.

Cited by 20 publications

References 20 publications

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

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

Does the Time From Biopsy to Radical Prostatectomy Affect Gleason Score Upgrading in Patients With Clinical T1c Prostate Cancer?

Nomograms as Predictive Tools for Prostate Cancer Patients Who Had Radical Prostatectomy

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