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

Stark, Jennifer R.; Perner, Sven; Stampfer, Meir J.; Sinnott, Jennifer A.; Finn, Stephen P.; Eisenstein, Anna; Ma, Jing; Fiorentino, Michelangelo; Kurth, Tobias; Loda, Massimo; Giovannucci, Edward; Rubin, Mark A.; Mucci, Lorelei A.

doi:10.1200/jco.2008.20.4669

Cited by 344 publications

(280 citation statements)

References 33 publications

Supporting

Mentioning

266

Contrasting

Unclassified

Order By: Relevance

“…The prognosis of patients with this score varies considerably based on the (Chan et al, 2000, Makarov et al, 2002, Rasiah et al, 2003 (as mentioned earlier the first number indicates the most common tumor pattern). Up to three-fold increase in the mortality of patients with score 4+3 has been reported compared to patients with Gleason score 3+4 (Stark et al, 2009). Due to our relatively small sample size we were not able to assess the impact of most prevalent tumor patterns on patient survival.…”

Section: Discussionmentioning

confidence: 99%

Survival of Patients with Prostate Cancer in Yazd, Iran

Zahir

Nazemian²,

Zand³

et al. 2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: Prostate cancer is the second leading cause of cancer death in men worldwide. Several factors such as availability of screening tests, and dietary, other lifestyle, environmental and genetic influences contribute to worldwide disparities in prostate cancer incidence and mortality rates. Our aims were to investigate patient characteristics at the time of diagnosis, common treatment strategies employed and survival in an Iranian male population with prostate cancer. Materials and Methods: Archives of Pathology Departments of five referral centers affiliated with the School of Medicine of Shahid Sadoughi University in Yazd province were reviewed. Paraffin-embedded blocks were reviewed by two independent pathologists to confirm the diagnosis. The latest modification of the Gleason Scoring System was adopted to determine pathological grading. Following pathological evaluation, patients were contacted via telephone to acquire information regarding their current status. Results: Pathology blocks were available for 113 patients. However, upon phone contacts, we were unable to determine the survival status in 23 patients (response rate=83%). Therefore, 90 patients were enrolled in the final analysis. The median follow-up time was 6.0 years (ranging from 0.3 to 8.8 years). There were 30 death attributed to prostate cancer in the study group. Kaplan-Meier analysis revealed that patient age at the time of diagnosis was a significant predictor of survival. Another significant predictor of poorer survival was higher tumor grade. Conclusions: Our observations indicate that age and pathological grade can negatively affect survival of individuals with prostate cancer in Iran.

show abstract

Section: Discussionmentioning

confidence: 99%

Survival of Patients with Prostate Cancer in Yazd, Iran

Zahir

Nazemian²,

Zand³

et al. 2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…However, a great discrepancy remains, since no statistically significant correlation between immunoreactive LAT1 expression and Gleason score has been detected in studies conducted by Sakata et al (7). Gleason scores were grouped using individual scores from 5 to 10, while urologists and pathologists usually divide the Gleason scores into two or three groups: low and high GS groups, or low, middle, and high GS groups (21)(22)(23). We estimated that this could be the reason why Sakata et al (7) did not demonstrate a significant association between LAT1 expression and Gleason score.…”

Section: Discussionmentioning

confidence: 99%

“…The pStage distribution by the TNM classification was as follows: pStage I or II, n=29; pStage III or IV, n=25. Since the Gleason score is well-known to be markedly correlated with lethal risk for patients following treatment, we divided the 54 patients into two groups, comprising a high (Gleason score of 4+3=7, ≥8) and a low GS group (Gleason score 3+4=7, ≤6), according to the findings of previously published studies (21)(22)(23). Overall, 26 patients were in the high and 28 patients in the low GS group.…”

Section: Patient Characteristicsmentioning

confidence: 99%

L-type amino acid transporter 1 expression is highly correlated with Gleason score in prostate cancer

Segawa

Nagamori

Kanai

et al. 2012

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Upregulation of L-type amino acid transporter 1 (LAT1), a member of the system L amino acid transporter family, may be detected by immunohistochemical methods. Immunoreactive LAT1 expression in prostate cancer is considered to be a promising biomarker for high-grade malignancy. However, the mutual association between LAT1 and Gleason score, the most fixed indicator for grading the malignancy of prostate cancers, remains to be elucidated. The aim of this study was to clarify the correlations between LAT1 and other factors in prostate cancer, including the Gleason score. We evaluated 54 cases of primary prostate cancer, surgically resected without any neoadjuvant therapies and performed immunohistochemistry for LAT1, Ki-67, CD34 and vascular endothelial growth factor on the tissue sections. The Gleason score as well as the age, pathological stage (pStage) of prostate cancer and serum concentration of prostate-specific antigen (PSA) of each case were also assessed. Statistical analysis for the correlations between LAT1 expression and Gleason score and each of the other characteristics studied was performed. As a result, a strong significant correlation between immunoreactive LAT1 expression and Gleason score was identified (P<0.01). We concluded that immunoreactive LAT1 expression in tissue sections of prostate cancer may be useful as a biomarker for high-grade malignancy.

show abstract

“…A major advantage of the Gleason system is the possibility to subclassify the large group of Gleason score 7 cancers according to the dominant primary pattern into Gleason score 7a (3 + 4 = 7) and 7b (4 + 3 = 7), which more precisely separates intermediate-from high-grade cancers. 36 Using the Helpap system, all these cancers were subsumed as grade 2b cancers without the possibility of a further subclassification. The opposite has been shown to be true for biopsy Gleason score 6 cancers.…”

Section: Discussionmentioning

confidence: 99%

Combined histoarchitectural and cytological biopsy grading improves grading accuracy in low‐grade prostate cancer

Helpap

Köllermann

2011

Int J of Urology

View full text Add to dashboard Cite

Abbreviations & AcronymsObjectives: Accurate tumor grading on prostate biopsy represents the mainstay for therapy planning. Biopsy undergrading is a persistent diagnostic dilemma with therapeutic relevance. We questioned whether Gleason grading combined with an established alternative grading system incorporating cytological parameters improves grading accuracy. Methods: Needle biopsies of 968 patients and the corresponding radical prostatectomy specimens were graded according to the Gleason grading system. In addition, all biopsies were graded according to the histo-and cytological grading system of Helpap. Biopsy Gleason grade, as well as the combined Gleason/Helpap grade, was compared with the final Gleason score and the pathological tumor-stage of the corresponding radical prostatectomy. Results: In biopsy Gleason score 6 cancers, an upgrading was seen in 76.0% of the patients (98/129), and 30.2% of them (39/129) showed non-organ confined disease. In combined biopsy Gleason 6/Helpap 2a patients, a final Gleason score of 6 was found in 22 out of 24 patients (91.7%, P < 0.0001), and all 24 patients showed organ-confined disease (pT2a). In biopsy Gleason 6/Helpap 2b cancers, a final Gleason score of 6 was found in just 9 out of 105 patients (8.6%), and the rate of organ-confined disease decreased to 62.8% (66/105, P = 0.0001). In higher Gleason grades, combined biopsy grading failed to show a diagnostic benefit over sole Gleason grading. Conclusion: Combined biopsy Gleason/Helpap grading improves the identification of low-grade/low-stage cancers and might contribute to more precise therapy planning in prostate cancer management.

show abstract

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

Cited by 344 publications

References 33 publications

Survival of Patients with Prostate Cancer in Yazd, Iran

Survival of Patients with Prostate Cancer in Yazd, Iran

L-type amino acid transporter 1 expression is highly correlated with Gleason score in prostate cancer

Combined histoarchitectural and cytological biopsy grading improves grading accuracy in low‐grade prostate cancer

Contact Info

Product

Resources

About