Abstract | PURPOSE: Gleason Score 7 prostate cancer comprises a wide spectrum of disease risk, and precise substratification is paramount. Our group previously demonstrated that the total length of Gleason pattern ( GP) 4 is a better predictor than % GP4 for adverse pathological outcomes at radical prostatectomy. We aimed to determine the association of GP4 length on prostate biopsy with post- prostatectomy oncologic outcomes. MATERIALS AND METHODS: We compared 4 GP4 quantification methods-including maximum % GP4 in any single core, overall % GP4, total length GP4 (mm) across all cores and length GP4 (mm) in the highest volume core-for prediction of biochemical recurrence-free survival after radical prostatectomy using multivariable Cox proportional hazards regression. RESULTS: A total of 457 men with grade group 2 prostate cancer on biopsy subsequently underwent radical prostatectomy. The 3-year biochemical recurrence-free survival probability was 85% (95% CI 81-88). On multivariable analysis, all 4 GP4 quantification methods were associated with biochemical recurrence-maximum % GP4 (HR=1.30; 95% CI 1.07-1.59; p=0.009), overall % GP4 (HR=1.61; 95% CI 1.21-2.15; p=0.001), total length GP4 (HR=2.48; 95% CI 1.36-4.52; p=0.003) and length GP4 in highest core (HR=1.32; 95% CI 1.11-1.57; p=0.001). However, we were unable to identify differences between methods of quantification with a relatively low event rate. CONCLUSIONS:
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Authors | Marlon Perera, Melissa J Assel, Nicole E Benfante, Andrew J Vickers, Victor E Reuter, Sigrid Carlsson, Vincent Laudone, Karim A Touijer, James A Eastham, Peter T Scardino, Samson W Fine, Behfar Ehdaie |
Journal | The Journal of urology
(J Urol)
Vol. 208
Issue 2
Pg. 309-316
(08 2022)
ISSN: 1527-3792 [Electronic] United States |
PMID | 35363038
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Prostate-Specific Antigen
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Topics |
- Biopsy
- Humans
- Male
- Neoplasm Grading
- Neoplasm Recurrence, Local
(pathology)
- Prostate
(pathology, surgery)
- Prostate-Specific Antigen
- Prostatectomy
- Prostatic Neoplasms
(pathology)
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