ORLANDO, FL, USA (UroToday.com) - The group from Germany investigated the association of Gleason score 6 pathology to development of metastatic castrate-resistant prostate cancer.
Patients participating in the COU-301 trial, AFFIRM trial, as well as patients with mCRPC from the group’s outpatient clinic were retrospectively evaluated. Clinical data was assessed for patients with confirmed mCRPC between 3/2007 to 10/2014.
Out of 605 screened patients, a total of 77 patients with confirmed mCRPC were identified. Distribution of Gleason scores for Gleason 6, 7, 8, 9, and 10 were 2, 24, 28, 18, and 5 patients, respectively. Pathological whole prostate specimen obtained from radical prostatectomy was available in 43/77 patients. The remainder of patients either underwent androgen deprivation therapy only, systemic therapy, or radiation therapy. None of the two patients with Gleason score 6 with mCRPC underwent radical prostatectomy. One underwent brachytherapy and another had primary ADT. The authors hypothesize likely understaging at prostate biopsy in these 2 patients with Gleason score 6. Out of the confirmed final whole prostate pathology, none had Gleason score < 7.
A total of 29 patients died during follow-up. Gleason score at initial diagnosis was not a significant prognosticator for overall survival.
The group concluded a likely non significant occurrence of mCRPC during the development of prostate cancer for patients with Gleason pathology < 7. Nonetheless, patients with Gleason score 6 on prostate biopsy still need to be counseled about the probability of under-staging.
Presented by Christoph A. J. von Klot, Alena Boeker, Thomas R. W. Herrmann, Mario W. Kramer, Markus A. Kuczyk, and Axel S. Merseburger at the 2015 Genitourinary Cancers Symposium - "Integrating Biology Into Patient-Centric Care" - February 26 - 28, 2015 - Rosen Shingle Creek - Orlando, Florida USA
Department of Urology and Urologic Oncology, Medical School Hannover, Hannover, Germany; Hannover Medical School, Hannover, Germany; Department of Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany
Reported by Mohammed Haseebuddin, MD, medical writer for UroToday.com