OBJECTIVE: To explore the rate of significant upgrading from biopsy to radical prostatectomy (RP) specimens in a contemporary cohort, and to develop a prognostic model capable of predicting the probability of significant upgrading, as previous reports indicate that up to 43% of men with low-grade prostate cancer at biopsy will be diagnosed with high-grade cancer at RP. PATIENTS AND METHODS: The study cohort comprised 4789 men (median age 63 years, range 39-82) treated with RP, with available clinical stage, prostate-specific antigen levels, biopsy and RP Gleason sum values. These variables were used as predictors in multivariate logistic regression models (LRMs) addressing the rate of significant Gleason sum upgrading, defined as a Gleason sum increase either from < or = 6 to > or = 7 or from 7 to > or = 8 between the biopsy and RP specimens. Regression coefficients were used to develop and validate (200 bootstrap re-samples) a nomogram predicting significant biopsy Gleason sum upgrading. RESULTS: Significant biopsy Gleason sum upgrading was recorded in 1349 (28.2%) patients. In multivariate LRMs, all predictors were highly significant (all P < 0.001). The bootstrap-corrected accuracy of the nomogram predicting the probability of significant Gleason sum upgrading between biopsy and RP specimens was 75.7%. CONCLUSION: Our nomogram might prove highly useful when the possibility of a more aggressive Gleason variant could change the treatment options.
OBJECTIVE: To explore the rate of significant upgrading from biopsy to radical prostatectomy (RP) specimens in a contemporary cohort, and to develop a prognostic model capable of predicting the probability of significant upgrading, as previous reports indicate that up to 43% of men with low-grade prostate cancer at biopsy will be diagnosed with high-grade cancer at RP. PATIENTS AND METHODS: The study cohort comprised 4789 men (median age 63 years, range 39-82) treated with RP, with available clinical stage, prostate-specific antigen levels, biopsy and RP Gleason sum values. These variables were used as predictors in multivariate logistic regression models (LRMs) addressing the rate of significant Gleason sum upgrading, defined as a Gleason sum increase either from < or = 6 to > or = 7 or from 7 to > or = 8 between the biopsy and RP specimens. Regression coefficients were used to develop and validate (200 bootstrap re-samples) a nomogram predicting significant biopsy Gleason sum upgrading. RESULTS: Significant biopsy Gleason sum upgrading was recorded in 1349 (28.2%) patients. In multivariate LRMs, all predictors were highly significant (all P < 0.001). The bootstrap-corrected accuracy of the nomogram predicting the probability of significant Gleason sum upgrading between biopsy and RP specimens was 75.7%. CONCLUSION: Our nomogram might prove highly useful when the possibility of a more aggressive Gleason variant could change the treatment options.
Authors: Ihab A Hekal; Nasr A El-Tabey; Mohamed Adel Nabeeh; Ahmed El-Assmy; Mohamed Abd El-Hameed; Adel Nabeeh; Elhousseiny I Ibrahiem Journal: Int Urol Nephrol Date: 2009-11-10 Impact factor: 2.370
Authors: Vikas Mehta; Kevin Rycyna; Bart M M Baesens; Güliz A Barkan; Gladell P Paner; Robert C Flanigan; Eva M Wojcik; Girish Venkataraman Journal: Int J Clin Exp Pathol Date: 2012-07-29
Authors: Anouk A M A van der Aa; Christophe K Mannaerts; Hans van der Linden; Maudy Gayet; Bart Ph Schrier; Massimo Mischi; Harrie P Beerlage; Hessel Wijkstra Journal: World J Urol Date: 2018-02-01 Impact factor: 4.226
Authors: Antonio B Porcaro; Salvatore Siracusano; Nicolò de Luyk; Paolo Corsi; Marco Sebben; Alessandro Tafuri; Daniele Mattevi; Leonardo Bizzotto; Irene Tamanini; Maria A Cerruto; Guido Martignoni; Matteo Brunelli; Walter Artibani Journal: Curr Urol Date: 2017-07-30
Authors: Shahrokh F Shariat; Michael W Kattan; Andrew J Vickers; Pierre I Karakiewicz; Peter T Scardino Journal: Future Oncol Date: 2009-12 Impact factor: 3.404