PURPOSE: Prostate cancer Gleason score 3 + 3 = 6 is currently the most common score assigned on prostatic biopsies. We analyzed the clinical variables that predict the likelihood of a patient with biopsy Gleason score 6 to harbor a higher grade tumor. MATERIALS AND METHODS: The study population consisted of 448 patients with a mean age of 59.1 years who underwent radical prostatectomy between February 2003 to October 2006 for Gleason score 6 adenocarcinoma. The effect of preoperative variables on the probability of a Gleason score upgrade on final pathological evaluation was evaluated using logistic regression, and classification and regression tree analysis. RESULTS: Gleason score upgrade was found in 91 of 448 patients (20.3%). Logistic regression showed that only serum prostate specific antigen and the greatest percent of cancer in a core were significantly associated with a score upgrade (p = 0.0014 and 0.023, respectively). Classification and regression tree analysis showed that the risk of a Gleason score upgrade was 62% when serum prostate specific antigen was higher than 12 ng/ml and 18% when serum prostate specific antigen was 12 ng/ml or less. In patients with serum prostate specific antigen lower than 12 ng/ml the risk of a score upgrade could be dichotomized at a greatest percent of cancer in a core of 5%. The risk was 22.6% and 10.5% when the greatest percent of cancer in a core was higher than 5% and 5% or lower, respectively. CONCLUSIONS: The probability of patients with a prostate biopsy Gleason score of 6 to conceal a Gleason score of 7 or higher can be predicted using serum prostate specific antigen and the greatest percent of cancer in a core. With these parameters it is possible to predict upgrade rates as high as 62% and as low as 10.5%.
PURPOSE:Prostate cancer Gleason score 3 + 3 = 6 is currently the most common score assigned on prostatic biopsies. We analyzed the clinical variables that predict the likelihood of a patient with biopsy Gleason score 6 to harbor a higher grade tumor. MATERIALS AND METHODS: The study population consisted of 448 patients with a mean age of 59.1 years who underwent radical prostatectomy between February 2003 to October 2006 for Gleason score 6 adenocarcinoma. The effect of preoperative variables on the probability of a Gleason score upgrade on final pathological evaluation was evaluated using logistic regression, and classification and regression tree analysis. RESULTS: Gleason score upgrade was found in 91 of 448 patients (20.3%). Logistic regression showed that only serum prostate specific antigen and the greatest percent of cancer in a core were significantly associated with a score upgrade (p = 0.0014 and 0.023, respectively). Classification and regression tree analysis showed that the risk of a Gleason score upgrade was 62% when serum prostate specific antigen was higher than 12 ng/ml and 18% when serum prostate specific antigen was 12 ng/ml or less. In patients with serum prostate specific antigen lower than 12 ng/ml the risk of a score upgrade could be dichotomized at a greatest percent of cancer in a core of 5%. The risk was 22.6% and 10.5% when the greatest percent of cancer in a core was higher than 5% and 5% or lower, respectively. CONCLUSIONS: The probability of patients with a prostate biopsy Gleason score of 6 to conceal a Gleason score of 7 or higher can be predicted using serum prostate specific antigen and the greatest percent of cancer in a core. With these parameters it is possible to predict upgrade rates as high as 62% and as low as 10.5%.
Authors: Ardeshir R Rastinehad; Angelo A Baccala; Paul H Chung; Juan M Proano; Jochen Kruecker; Sheng Xu; Julia K Locklin; Baris Turkbey; Joanna Shih; Gennady Bratslavsky; W Marston Linehan; Neil D Glossop; Pingkun Yan; Samuel Kadoury; Peter L Choyke; Bradford J Wood; Peter A Pinto Journal: J Urol Date: 2011-01-15 Impact factor: 7.450
Authors: Yahui Peng; Yulei Jiang; Cheng Yang; Jeremy Bancroft Brown; Tatjana Antic; Ila Sethi; Christine Schmid-Tannwald; Maryellen L Giger; Scott E Eggener; Aytekin Oto Journal: Radiology Date: 2013-02-07 Impact factor: 11.105
Authors: Hasmet Sarici; Onur Telli; Orhan Yigitbasi; Musa Ekici; Berat Cem Ozgur; Cem Nedim Yuceturk; Muzaffer Eroglu Journal: Can Urol Assoc J Date: 2014-05 Impact factor: 1.862
Authors: Nitin K Yerram; Dmitry Volkin; Baris Turkbey; Jeffrey Nix; Anthony N Hoang; Srinivas Vourganti; Gopal N Gupta; W Marston Linehan; Peter L Choyke; Bradford J Wood; Peter A Pinto Journal: BJU Int Date: 2012-11-06 Impact factor: 5.588