Prostate volume effect on Gleason score upgrading in active surveillance appropriate patients

被引:8
作者
Camur, Emre [1 ]
Coskun, Alper [2 ]
Kavukoglu, Ovunc [3 ]
Can, Utku [4 ]
Kara, Onder [5 ]
Camur, Arzu Develi [6 ]
Sarica, Kemal [7 ]
Narter, Kamil Fehmi [8 ,9 ]
机构
[1] Amasya Univ, Sabuncuoglu Serefeddin Training & Res Hosp, Urol Dept, Amasya, Turkey
[2] Sanliurfa Training & Res Hosp, Urol Clin, Sanliurfa, Turkey
[3] Gumushane State Hosp, Urol Clin, Gumushane, Turkey
[4] Erzurum Training & Res Hosp, Urol Clin, Erzurum, Turkey
[5] Kocaeli Univ, Med Fac Hosp, Urol Clin, Kocaeli, Turkey
[6] Suluova State Hosp, Internal Med Clin, Amasya, Turkey
[7] Kafkas Univ, Training & Res Hosp, Urol Clin, Kars, Turkey
[8] Acibadem Mehmet Ali Aydinlar Univ Hosp, Urol Clin, Istanbul, Turkey
[9] Acibadem Univ Hosp, Urol Clin, Istanbul, Turkey
关键词
Prostate cancer; Gleason score; Upgrading; Active surveillance; RADICAL PROSTATECTOMY; NEEDLE-BIOPSY; CANCER; RADIATION; PREDICTOR; VARIABLES; ACCURACY; ANTIGEN;
D O I
10.4081/aiua.2019.2.93
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Gleason Score (GS) upgrading rates in the literature are reported to be around 33-45%. The relationship between prostate volume and GS upgrading should be defined, aiming to reduce upgrading rates in patients with low risk groups who are eligible for active surveillance (AS) or minimally invasive treatment, by varying biopsy cores, or lengths of cores according to prostate volumes. In this regard, the aim of our study was to establish the relationship between prostate volume and GS upgrading. Materials and methods: We retrospectively analyzed the medical records of 78 patients, who were appropriate for AS between 2011-2016 at our hospital. Inclusion criteria were patient age under 65 years, PSA level under 10 ng/ml, GS (3 + 3) or (3 + 4), and 3 or less positive cores, clinical stages <= T2. GS increase in radical prostatectomy specimen was considered as 'upgrading' and in addition, score reported by biopsy as 3 + 4 but in surgical specimen as 4 + 3 were also considered as 'upgrading'. The effect of prostate volume on Gleason grade upgrading was examined by calculating upgrading rates separately for patients with prostate volume 30 ml or less, those with 30 to 60 ml, and those over 60 ml. Results: As a result of the analysis of the data, upgrading was seen in 35 (44.8%) of 78 patients included in the study. In the cohort mean prostate volume was 49.8 (+/- 26.3) ml. Twenty-two patients (28.2%) had prostate volume 30 ml or less, 34 (43.6%) 30 to 60 ml, and 22 (28.2%) 60 ml or more. The patients were divided into two groups as those with and without GS upgrading. Between the groups prostate volume and prostate volume range (0-30/31-60/> 60) were not significantly different (p value > 0.05). Conclusions: Gleason grade upgrading causes patients to be classified in a lower risk group than they actually are, and may lead to inappropriate treatment. This condition has a direct effect on the decision of active surveillance. Therefore, it is important to define the factors that can predict GS upgrading in active surveillance appropriate patients. In this study, we found that prostate volume has no significant effect on upgrading in active surveillance appropriate patients.
引用
收藏
页码:93 / 96
页数:4
相关论文
共 29 条
[1]  
Bostwick D G., 2014, Urologic Surgical Pathology, V3rd, P408
[2]   Is Small Prostate Volume a Predictor of Gleason Score Upgrading after Radical Prostatectomy? [J].
Chung, Mun Su ;
Lee, Seung Hwan ;
Lee, Dong Hoon ;
Chung, Byung Ha .
YONSEI MEDICAL JOURNAL, 2013, 54 (04) :902-906
[3]   Cancer-specific mortality after surgery or radiation for patients with clinically localized prostate cancer managed during the prostate-specific antigen era [J].
D'Amico, AV ;
Moul, J ;
Carroll, PR ;
Sun, L ;
Lubeck, D ;
Chen, MH .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (11) :2163-2172
[4]   Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer [J].
D'Amico, AV ;
Whittington, R ;
Malkowicz, SB ;
Schultz, D ;
Blank, K ;
Broderick, GA ;
Tomaszewski, JE ;
Renshaw, AA ;
Kaplan, I ;
Beard, CJ ;
Wein, A .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 280 (11) :969-974
[5]   Prostate Size as a Predictor of Gleason Score Upgrading in Patients With Low Risk Prostate Cancer [J].
Davies, Judson D. ;
Aghazadeh, Monty A. ;
Phillips, Sharon ;
Salem, Shady ;
Chang, Sam S. ;
Clark, Peter E. ;
Cookson, Michael S. ;
Davis, Rodney ;
Herrell, S. Duke ;
Penson, David F. ;
Smith, Joseph A., Jr. ;
Barocas, Daniel A. .
JOURNAL OF UROLOGY, 2011, 186 (06) :2221-2227
[6]   Increased accuracy of biopsy Gleason score obtained by extended needle biopsy [J].
Emiliozzi, P ;
Maymone, S ;
Paterno, A ;
Scarpone, P ;
Amini, M ;
Proietti, G ;
Cordahi, M ;
Pansadoro, V .
JOURNAL OF UROLOGY, 2004, 172 (06) :2224-2226
[7]   Diagnosis and reporting of limited adenocarcinoma of the prostate on needle biopsy [J].
Epstein, JI .
MODERN PATHOLOGY, 2004, 17 (03) :307-315
[8]   Upgrading and downgrading of prostate needle biopsy specimens: Risk factors and clinical implications [J].
Freedland, Stephen J. ;
Kane, Christopher J. ;
Amling, Christopher L. ;
Aronson, William J. ;
Terris, Martha K. ;
Presti, Joseph C., Jr. .
UROLOGY, 2007, 69 (03) :495-499
[9]   What is the optimal definition of misclassification in patients with very low-risk prostate cancer eligible for active surveillance? Results from a multi-institutional series [J].
Gandaglia, Giorgio ;
Ploussard, Guillaume ;
Isbarn, Hendrik ;
Suardi, Nazareno ;
De Visschere, Peter J. L. ;
Futterer, Jurgen J. ;
Ghadjar, Pirus ;
Massard, Christophe ;
Ost, Piet ;
Sooriakumaran, Prasanna ;
Surcel, Christian I. ;
van den Bergh, Roderick C. N. ;
Montorsi, Francesco ;
Ficarra, Vincenzo ;
Giannarini, Gianluca ;
Briganti, Alberto .
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, 2015, 33 (04) :164.e1-164.e9
[10]   Prediction of Gleason score upgrading in low-risk prostate cancers diagnosed via multi (≥12)-core prostate biopsy [J].
Hong, Sung Kyu ;
Han, Byung Kyu ;
Lee, Seung Tae ;
Kim, Sung Soo ;
Min, Kyung Eun ;
Jeong, Sung Jin ;
Jeong, Hyeon ;
Byun, Seok-Soo ;
Lee, Hak Jong ;
Choe, Gheeyoung ;
Lee, Sang Eun .
WORLD JOURNAL OF UROLOGY, 2009, 27 (02) :271-276