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- Title
Prediction of Gleason score upgrading in low-risk prostate cancers diagnosed via multi (≥12)-core prostate biopsy.
- Authors
Sung Kyu Hong; Byung Kyu Han; Seung Tae Lee; Sung Soo Kim; Kyung Eun Min; Sung Jin Jeong; Hyeon Jeong; Seok-Soo Byun; Hak Jong Lee; Gheeyoung Choe; Sang Eun Lee
- Abstract
A paucity of data exists on actual pathology of the contemporary patients strictly categorized as having low-risk prostate cancer. We tried to identify useful preoperative predictors of Gleason score upgrading in patients who underwent radical retropubic prostatectomy (RRP) for low-risk prostate cancer diagnosed via multi-core prostate biopsy. A total of 203 patients who underwent radical RRP for low-risk prostate cancer, as defined by D’Amico et al.'s classification (clinical stage ≤T2a, biopsy Gleason sum ≤6, and PSA ≤10 ng/ml), detected via multi (≥12)-core prostate biopsy were enrolled. We reviewed patients preoperative and pathological data. Among all subjects, 81 (39.9%) were upgraded to Gleason score ≥7 after RRP, whereas no downgrading was observed. In multivariate analysis, only preoperative PSA level ( P = 0.024) and number of positive cores ( P = 0.027) were observed to be independent predictors of Gleason score upgrading following RRP. Also, Gleason core upgrading was observed to be significantly associated with extraprostatic extension of tumor ( P < 0.001) and positive surgical margin ( P = 0.002). A significant proportion of patients with low-risk prostate cancer as defined by D’Amico et al.’s classification diagnosed via multi-core prostate biopsy in contemporary period may have Gleason score upgrading following RRP. For patients with low-risk prostate cancer, preoperative PSA level and number of positive cores may be useful predictors of Gleason score upgrading, which was observed to significantly associated with other adverse pathologic features.
- Publication
World Journal of Urology, 2009, Vol 27, Issue 2, p271
- ISSN
0724-4983
- Publication type
Academic Journal
- DOI
10.1007/s00345-008-0343-3