Predicting the Gleason sum of a patient with a prostate biopsy core Gleason ≤ 7 and a prostate biopsy core Gleason ≥ 8 - Abstract

INTRODUCTION: We review a subset of men who had discordant prostate biopsy sums and were treated with radical prostatectomy.

METHODS: Consecutive patients treated with radical prostatectomy at The Ottawa Hospital between 2000 and 2012 were reviewed. Those with at least 1 prostate biopsy core of Gleason sum ≥8 and at least 1 prostate biopsy core of Gleason sum ≤ 7 cancer were included.

RESULTS: Of the 764 radical prostatectomies, 661 (87%) were eligible for the study and 35 (5%) met inclusion criteria. Of these, only 16 (46%) had prostatectomy Gleason sum of ≥8. When the highest biopsy core was Gleason sum 8 (n = 24), only 7 (29%) had a prostatectomy Gleason sum ≥8. When the highest biopsy core was Gleason 9 (n = 11), 9 (82%) had a prostatectomy Gleason sum ≥8 (relative risk [RR] 2.8; p = 0.004). Patients with clinical T3 tumours were at higher risk of Gleason sum ≥8 compared to cT1 patients (RR 3.7; p = 0.008). Patient age (p = 0.89), preoperative prostate-specific antigen (p = 0.34), prostate volume (p = 0.86), number of biopsy cores (p = 0.18), and proportion of biopsy cores with cancer (p = 0.96) were not strongly associated with risk of prostatectomy Gleason sum ≥8.

CONCLUSION: These data should be considered when assigning patients into prognostic risk categories based on prostate biopsy information. Further study to verify our findings using larger samples is warranted.

Written by:
Heimrath OP, Kos Z, Belanger EC, Cagiannos I, Morash C, Gerridzen RG, Lavallée LT, Preston MA, Witiuk K, Breau RH.   Are you the author?
University of Ottawa, Ottawa, ON; Division of Urology, Department of Surgery, McGill University, Montreal, QC; University of Ottawa, Ottawa, ON; Division of Anatomical Pathology, Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON; University of Ottawa, Ottawa, ON; ; Division of Urology, Department of Surgery, The Ottawa Hospital, Ottawa, ON; Department of Urology, Massachusetts General Hospital, Boston, MA; Ottawa Hospital Research Institute, Ottawa, ON; University of Ottawa, Ottawa, ON; Division of Urology, Department of Surgery, The Ottawa Hospital, Ottawa, ON; Ottawa Hospital Research Institute, Ottawa, ON.

Reference: Can Urol Assoc J. 2014 Jul;8(7-8):E476-80.
doi: 10.5489/cuaj.1737


PubMed Abstract
PMID: 25132892

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