OBJECTIVE: To identify clinical factors associated with prostate cancer (PCA) upgrading to higher patterns of the surgical specimen in low-risk PCA. MATERIALS AND METHODS: We evaluated the records of 438 patients. The multinomial logistic regression model was used. RESULTS: Low-risk PCA included 170 cases (38.8%) and tumor upgrading was detected in 111 patients (65.3%) of whom 72 (42.4%) had pathological Gleason patterns (pGP) = 3 + 4 and 39 (22.9%) pGP >3 + 4. Prostate-specific antigen (PSA) and proportion of positive cores (P+) were independent predictors of tumor upgrading to higher patterns. The main difference between upgraded cancers related to PSA and to P+ >0.20. The population was stratified into risk classes by PSA ≤5 μg/l and P+ ≤0.20 (class A), PSA >5 μg/l and P+ ≤0.20 (class B), PSA ≤5 μg/l and P+ >0.20 (class C) and PSA >5 μg/l and P+ 0.20 (class D). Upgrading rates to pGP >3 + 4 were extremely low in class A (5.1%), extremely high in D (53.8%). CONCLUSIONS: Low-risk PCA is a heterogeneous population with significant rates of undetected high-grade disease. Significant clinical predictors of upgrading to higher patterns include PSA and P+, which identify a very high-risk class that needs repeat biopsies in order to reclassify tumor grade.
OBJECTIVE: To identify clinical factors associated with prostate cancer (PCA) upgrading to higher patterns of the surgical specimen in low-risk PCA. MATERIALS AND METHODS: We evaluated the records of 438 patients. The multinomial logistic regression model was used. RESULTS: Low-risk PCA included 170 cases (38.8%) and tumor upgrading was detected in 111 patients (65.3%) of whom 72 (42.4%) had pathological Gleason patterns (pGP) = 3 + 4 and 39 (22.9%) pGP >3 + 4. Prostate-specific antigen (PSA) and proportion of positive cores (P+) were independent predictors of tumor upgrading to higher patterns. The main difference between upgraded cancers related to PSA and to P+ >0.20. The population was stratified into risk classes by PSA ≤5 μg/l and P+ ≤0.20 (class A), PSA >5 μg/l and P+ ≤0.20 (class B), PSA ≤5 μg/l and P+ >0.20 (class C) and PSA >5 μg/l and P+ 0.20 (class D). Upgrading rates to pGP >3 + 4 were extremely low in class A (5.1%), extremely high in D (53.8%). CONCLUSIONS: Low-risk PCA is a heterogeneous population with significant rates of undetected high-grade disease. Significant clinical predictors of upgrading to higher patterns include PSA and P+, which identify a very high-risk class that needs repeat biopsies in order to reclassify tumor grade.
Authors: Kai Wang; Xinguang Chen; Victoria Y Bird; Travis A Gerke; Todd M Manini; Mattia Prosperi Journal: Int J Cancer Date: 2017-07-24 Impact factor: 7.396
Authors: Antonio B Porcaro; Alessandro Tafuri; Marco Sebben; Paolo Corsi; Tania Processali; Marco Pirozzi; Davide De Marchi; Davide Inverardi; Maria A Cerruto; Nelia Amigoni; Riccardo Rizzetto; Matteo Brunelli; Roberto Iacovelli; Salvatore Siracusano; Walter Artibani Journal: Curr Urol Date: 2019-07-20
Authors: Antonio Benito Porcaro; Alessandro Tafuri; Andrea Panunzio; Riccardo Rizzetto; Nelia Amigoni; Clara Cerrato; Aliasger Shakir; Sebastian Gallina; Alberto Bianchi; Francesco Cianflone; Emanuele Serafin; Alessandra Gozzo; Giacomo Di Filippo; Filippo Migliorini; Giovanni Novella; Matteo Brunelli; Maria Angela Cerruto; Alessandro Antonelli Journal: Int Urol Nephrol Date: 2021-09-27 Impact factor: 2.370