Prediction of outcomes after radical prostatectomy in patients diagnosed with prostate cancer of biopsy gleason score ≥ 8 via contemporary multi (≥12)‐core prostate biopsy

• Published in: BJU international Vol. 108; no. 2; pp. 217 - 222
• Main Authors: Hong, Sung Kyu, Oh, Jong Jin, Jeong, Sung Jin, Jeong, Chang Wook, Kim, In Sung, Park, Jung Min, Byun, Seok‐Soo, Choe, Gheeyoung, Lee, Hak Jong, Lee, Sang Eun
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2011; Wiley-Blackwell
• Subjects: Aged; Biological and medical sciences; biopsy; Biopsy, Needle; Epidemiologic Methods; Gleason score; Gynecology. Andrology. Obstetrics; Humans; Male; Male genital diseases; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Nephrology. Urinary tract diseases; Prognosis; prostate; Prostate - pathology; prostate neoplasms; Prostate-Specific Antigen - blood; prostatectomy; Prostatectomy - methods; Prostatic Neoplasms - mortality; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Treatment Outcome; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland; Histological grading; Gleason score; Prostate tumor; Nephrology; Prognosis; Prostate disease; Urology; Histopathology; Surgery; Diagnosis; Urogenital system; Male genital diseases; Human; Urinary system disease; Prediction; Malignant tumor; Anatomic pathology; Treatment; prostate neoplasms; Biopsy; Prostatectomy; Predictive factor; Prostate cancer; Prostate; Cancer
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2010.09814.x

Study Type – Prognostic (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Currently, controversy continues with regards to the efficacy of performing radical prostatectomy (RP) and the potential predictor of outcome after surgery in patients with prostate cancers of higher biopsy Gleason score. Among contemporary patients with biopsy Gleason score ≥8 who underwent RP alone, patients with pathologically organ‐confined disease demonstrated significantly better biochemical outcome than others. Serum PSA level and maximum tumour length in a biopsy core, independent predictors of organ‐confined disease, would be useful in the selection of candidates for RP among patients presenting with biopsy Gleason score ≥8. OBJECTIVE •  To investigate the outcome of patients who underwent radical prostatectomy (RP) for prostate cancer of biopsy Gleason score ≥ 8 diagnosed via contemporary prostate biopsy. PATIENTS AND METHODS •  We reviewed records of 151 patients who underwent RP for prostate cancer of biopsy Gleason score ≥ 8 detected via multi (≥12)‐core prostate biopsy without any neoadjuvant or adjuvant treatment. •  Preoperative predictors of pathologically organ‐confined disease along with biochemical recurrence‐free survival were analyzed via multivariate logistic regression and Cox proportional hazards model. RESULTS •  For 151 total subjects, 5‐year estimated biochemical recurrence‐free survival rate was 41.0%. Patients with pathologically organ‐confined disease were observed to have much higher 5‐year biochemical recurrence‐free survival rate than those otherwise (72.1 vs 31.5%, P < 0.001). •  Serum PSA level (P= 0.031) and maximum tumour length in a biopsy core (P= 0.005) were observed to be significant preoperative predictors of having pathologically organ‐confined disease. •  As for biochemical recurrence‐free survival following RP, serum PSA (P= 0.023), biopsy Gleason score (P= 0.032), and percent of total tumour length in biopsy cores (P < 0.001) were observed be significant preoperative predictors on multivariate analysis. CONCLUSION •  Among contemporary patients with biopsy Gleason score ≥ 8 who underwent RP alone, patients with pathologically organ‐confined disease demonstrated significantly better biochemical outcome than others. Serum PSA level and maximum tumour length in a biopsy core, independent predictors of organ‐confined disease, would be useful in the selection of candidates for RP among patients presenting with biopsy Gleason score ≥ 8.