Journal
INVESTIGATIVE AND CLINICAL UROLOGY
Volume 61, Issue 4, Pages 405-410Publisher
KOREAN UROLOGICAL ASSOC
DOI: 10.4111/icu.2020.61.4.405
Keywords
Pathology; Prognosis; Prostate neoplasms; Prostatectomy
Categories
Ask authors/readers for more resources
Purpose: Whether active surveillance (AS) can be safely extended to patients with Gleason score (GS) 3+4 prostate cancer is highly debated. We examined the incidence and predictors of upgrading among patients with GS 3+4 disease. Materials and Methods: The study involved 377 patients with biopsy GS 3+4 who underwent robot-assisted laparoscopic radical prostatectomy (RP) from 2014 to 2018 at a single institution. We analyzed the rate of GS upgrading and used logistic regression to determine the predictors of upgrading. Results: A total of 168 (44.6%) patients with GS 3+4 experienced an upgrade in GS. In multivariable analysis, advanced age, prostate-specific antigen (PSA) level, PSA density (PSAD) and Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) score were significant predictors of GS upgrading. When structured into a predictive model that included age >= 65 years, PSA >= 7.7 ng/mL, PSAD >= 0.475 ng/mL(2) and PI-RADS v2 score 4-5, the probability of GS upgrading ranged from 36.4% to 65.7% when one to four of these factors were included. Conclusions: A substantial proportion of patients with GS 3+4 prostate cancer were upgraded after RP. However, according to our model combining clinical and imaging predictors, patients with a low risk of GS upgrading may be eligible candidates for AS.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available