Disease-specific death and metastasis do not occur in patients with Gleason score ≤ 6 on radical prostatectomy - Abstract

OBJECTIVES: To assess the lymph node metastasis-free survival, distant metastasis-free survival and disease-specific survival in men with Gleason score ≤ 6 prostate cancer on radical prostatectomy.

PATIENTS AND METHODS: We included 1101 consecutive radical prostatectomy patients operated between March 1985 to July 2013 at a single institution. The outcome variables were metastasis-free survival and disease-specific survival. The postoperative survival was estimated by the Kaplan-Meier method.

RESULTS: The Gleason score distribution of the study population (n=1101) was Gleason score ≤ 6 (n=449, 41%), Gleason score 3+4=7 (n=436, 40%), Gleason score 4+3=7 (n=99, 9%) and Gleason score 8-10 (n=117, 11%). The median post-operative follow-up was 100 months (IQR 48-150). During follow-up 197 men (18%) died of whom 42 (3.8%) from prostate cancer related causes. A total of 19/1101 patients (1.7%) had documented lymph node metastasis at time of operation: 0 in Gleason score ≤ 6, 7 in Gleason score 3+4=7 (1.6%), 6 in Gleason score 4+3=7 (6.1%) and 6 in Gleason score 8-10 (5.1%). Distant metastasis occurred in 56/1101 patients (5.1%): 0 in Gleason score ≤ 6, 23 in Gleason score 3+4=7 (5.3%), 17 in Gleason score 4+3=7 (17%) and 16 in Gleason score 8-10 (14%). Disease-specific death, stratified per Gleason score group was: 0 in ≤ 6, 16 (3.7%) in 3+4=7, 16 (16%) in 4+3=7 and 10 (8.5%) in 8-10.

CONCLUSION: No metastasis or disease-specific death were observed in men with Gleason score ≤ 6 prostate cancer on radical prostatectomy, demonstrating the negligible potential to metastasize in this large subgroup of prostate cancer patients.

Written by:
Kweldam CF, Wildhagen MF, Bangma CH, van Leenders GJ.   Are you the author?
Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands.

Reference: BJU Int. 2014 Jul 25. Epub ahead of print.
doi: 10.1111/bju.12879


PubMed Abstract
PMID: 25060593

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