BACKGROUND: Gleason pattern 5 (GP5), including tertiary GP5, at radical prostatectomy has reportedly been associated with poorer clinical outcome. However, it is undetermined how tertiary GP5 is handled in the new Gleason grade grouping starting in 2016, and its prognostic value in patients undergoing salvage treatment for postoperative biochemical recurrence (BCR) remains unclear. METHODS: We retrospectively reviewed 116 patients with pT2-3N0M0 prostate cancer (PC) who received salvage treatment for BCR after radical prostatectomy between 2003 and 2014. The primary endpoint was failure of salvage treatment, defined as a single prostate-specific antigen (PSA) value ≥0.2 ng/ml after PSA nadir following salvage treatment. Associations of various clinicopathological factors, including GP5, with failure-free survival were assessed. Cox proportional hazards model was used for multivariate analysis. RESULTS: Patients received salvage treatment with either radiotherapy (n = 48), androgen-deprivation therapy (n = 61), or both (n = 7) for BCR. Twenty-three patients (19.8 %) experienced failure of salvage treatment, with a median follow-up period of 79 months. Univariate analysis associated GP5, Gleason score-based parameters, lymphovascular invasion, and PSA doubling time <6 months with poorer failure-free survival. Receiver operating characteristic curve analyses identified the area under the curve for GP5 (0.654) as the largest among those parameters (P = 0.0060). Multivariate analysis demonstrated that GP5 was the only independent predictor of poor outcome. CONCLUSIONS: The presence of GP5 is an independent predictor of poor prognosis in patients with pT2-3N0M0 PC undergoing salvage treatment for BCR after radical prostatectomy. GP5 may thus be a more useful marker than conventional Gleason score in this setting.
BACKGROUND: Gleason pattern 5 (GP5), including tertiary GP5, at radical prostatectomy has reportedly been associated with poorer clinical outcome. However, it is undetermined how tertiary GP5 is handled in the new Gleason grade grouping starting in 2016, and its prognostic value in patients undergoing salvage treatment for postoperative biochemical recurrence (BCR) remains unclear. METHODS: We retrospectively reviewed 116 patients with pT2-3N0M0 prostate cancer (PC) who received salvage treatment for BCR after radical prostatectomy between 2003 and 2014. The primary endpoint was failure of salvage treatment, defined as a single prostate-specific antigen (PSA) value ≥0.2 ng/ml after PSA nadir following salvage treatment. Associations of various clinicopathological factors, including GP5, with failure-free survival were assessed. Cox proportional hazards model was used for multivariate analysis. RESULTS:Patients received salvage treatment with either radiotherapy (n = 48), androgen-deprivation therapy (n = 61), or both (n = 7) for BCR. Twenty-three patients (19.8 %) experienced failure of salvage treatment, with a median follow-up period of 79 months. Univariate analysis associated GP5, Gleason score-based parameters, lymphovascular invasion, and PSA doubling time <6 months with poorer failure-free survival. Receiver operating characteristic curve analyses identified the area under the curve for GP5 (0.654) as the largest among those parameters (P = 0.0060). Multivariate analysis demonstrated that GP5 was the only independent predictor of poor outcome. CONCLUSIONS: The presence of GP5 is an independent predictor of poor prognosis in patients with pT2-3N0M0 PC undergoing salvage treatment for BCR after radical prostatectomy. GP5 may thus be a more useful marker than conventional Gleason score in this setting.
Authors: Liang Cheng; Michael O Koch; Beth E Juliar; Joanne K Daggy; Richard S Foster; Richard Bihrle; Thomas A Gardner Journal: J Clin Oncol Date: 2005-05-01 Impact factor: 44.544
Authors: Gerald W Hull; Farhang Rabbani; Farhat Abbas; Thomas M Wheeler; Michael W Kattan; Peter T Scardino Journal: J Urol Date: 2002-02 Impact factor: 7.450
Authors: William Jackson; Daniel A Hamstra; Skyler Johnson; Jessica Zhou; Benjamin Foster; Corey Foster; Darren Li; Yeohan Song; Ganesh S Palapattu; Lakshmi P Kunju; Rohit Mehra; Felix Y Feng Journal: Cancer Date: 2013-07-02 Impact factor: 6.860
Authors: Ilaria Lucca; Shahrokh F Shariat; Alberto Briganti; Yair Lotan; Claus G Roehrborn; Francesco Montorsi; Mesut Remzi; Christian Seitz; Harun Fajkovic; Christoph Klingler; Pierre I Karakiewicz; Maxine Sun; Morgan Rouprêt; Wolfgang Loidl; Karl Pummer; Tobias Klatte Journal: Urol Oncol Date: 2014-10-23 Impact factor: 3.498
Authors: Jonathan I Epstein; Lars Egevad; Mahul B Amin; Brett Delahunt; John R Srigley; Peter A Humphrey Journal: Am J Surg Pathol Date: 2016-02 Impact factor: 6.394
Authors: Hong Gee Sim; Donatello Telesca; Stephen H Culp; William J Ellis; Paul H Lange; Lawrence D True; Daniel W Lin Journal: J Urol Date: 2008-03-17 Impact factor: 7.450
Authors: Judd W Moul; Hongyu Wu; Leon Sun; David G McLeod; Christopher Amling; Timothy Donahue; Leo Kusuda; Wade Sexton; Keith O'Reilly; Javier Hernandez; Andrew Chung; Douglas Soderdahl Journal: J Urol Date: 2004-03 Impact factor: 7.450
Authors: Andrew J Stephenson; Peter T Scardino; Michael W Kattan; Thomas M Pisansky; Kevin M Slawin; Eric A Klein; Mitchell S Anscher; Jeff M Michalski; Howard M Sandler; Daniel W Lin; Jeffrey D Forman; Michael J Zelefsky; Larry L Kestin; Claus G Roehrborn; Charles N Catton; Theodore L DeWeese; Stanley L Liauw; Richard K Valicenti; Deborah A Kuban; Alan Pollack Journal: J Clin Oncol Date: 2007-05-20 Impact factor: 44.544