Stage at presentation and survival outcomes of patients with Gleason 8-10 prostate cancer and low prostate-specific antigen.

To evaluate outcomes for men with high Gleason score and low prostate-specific antigen (PSA) prostate cancer. Low PSA levels among men with Gleason 8-10 prostate cancer may be owing to cellular dedifferentiation rather than low disease burden.

We hypothesized that men with Gleason 8-10 prostate cancer and low PSA levels have increased risk for advanced disease and worse survival.

Men diagnosed from 2004 to 2007 with Gleason 8-10 prostate adenocarcinoma in the National Cancer Data Base were included. Patients were stratified by PSA levels at diagnosis: 0. 1 to 3. 9, 4. 0 to 9. 9, 10. 0 to 19. 9, and≥20. 0ng/ml. Outcomes were clinical TNM category, pathologic stage (for prostatectomy patients), and overall survival (OS). Kaplan-Meier analysis and Cox proportional hazards models were used.

A total of 37,283 patients were included. Men with PSA levels of

Patients with Gleason 8-10 cancer and PSA levels of

Urologic oncology. 2015 Oct 29 [Epub ahead of print]

Aaron D Falchook, Neil E Martin, Ramsankar Basak, Angela B Smith, Matthew I Milowsky, Ronald C Chen

Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC. , Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA. , Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC. , Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC; University of North Carolina-Lineberger Comprehensive Cancer Center, Chapel Hill, NC. , University of North Carolina-Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC. , Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC; University of North Carolina-Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC. 

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