Does a tertiary Gleason pattern 4 or 5 influence the risk of biochemical relapse after radical prostatectomy for clinically localized prostate cancer?

Autor:	Gudmund Waaler, Einar Servoll, Ljiljana Vlatkovic, Thorstein Sæter, Jahn M. Nesland, Hans Olav Beisland
Rok vydání:	2010
Předmět:	Biochemical recurrence Adult Male medicine.medical_specialty Surgical margin Urology medicine.medical_treatment Kaplan-Meier Estimate Prostate cancer Predictive Value of Tests Risk Factors medicine Biomarkers Tumor Humans Stage (cooking) Aged Proportional Hazards Models Retrospective Studies Prostatectomy Proportional hazards model Genitourinary system business.industry Prostatic Neoplasms Retrospective cohort study Middle Aged Prostate-Specific Antigen medicine.disease Prognosis Surgery Nephrology Neoplasm Recurrence Local business
Zdroj:	Scandinavian journal of urology and nephrology. 44(4)
ISSN:	1651-2065
Popis:	The presence of a tertiary Gleason grade (TGG) pattern 4 or 5 in radical prostatectomy (RP) specimens has been reported with adverse pathology and a higher biochemical relapse rate after RP. This study investigated the impact of a TGG pattern 4 or 5 on biochemical and pathological outcome in men operated with RP.The study reviewed 151 consecutive cases treated at the hospital between 1985 and 2006; 148 were included in the study. All prostatectomy specimens were re-examined by a genitourinary pathologist and among others parameters the presence of TGG pattern 4 or 5 was recorded. The hospital files were examined retrospectively for clinical follow-up data. Prostate-specific antigen (PSA) relapse was defined as two subsequent rising measurements above 0.20 ng/ml. The influence of a TGG pattern 4 or 5 on prognosis was assessed in a Cox proportional hazards regression model controlling for pathological stage, surgical margin (SM) status, seminal vesicle invasion (SVI) and extraprostatic extension (EPE).Fifty-six patients (38%) experienced PSA relapse during follow-up. Twenty-one patients (58%) with a TGG pattern 4 or 5 had a biochemical relapse compared with 35 patients (31%) without TGG pattern 4 or 5. In the Cox regression model, TGG pattern 4 or 5 was an independent predictor of biochemical failure (p = 0.020).In patients undergoing RP the presence of a TGG pattern 4 or 5 is an independent predictor for biochemical relapse. Consequently, the RP specimens should routinely be investigated for TGG pattern 4 or 5.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::83008c78afa149573de8ee1e37346d23 https://pubmed.ncbi.nlm.nih.gov/20367396 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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