Percentage Gleason pattern 4 and PI-RADS score predict upgrading in biopsy Grade Group 2 prostate cancer patients without cribriform pattern

Autor: Margaretha A. van der Slot, Neslisah Seyrek, Charlotte F. Kweldam, Michael A. den Bakker, Martijn B. Busstra, Melanie Gan, Sjoerd Klaver, John B. W. Rietbergen, Geert J. L. H. van Leenders
Přispěvatelé: Pathology, Urology
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: World Journal of Urology, 40(11), 2723-2729. Springer-Verlag
ISSN: 0724-4983
DOI: 10.1007/s00345-022-04161-6
Popis: Purpose To identify parameters to predict upgrading in biopsy Grade Group (GG) 2 prostate cancer patients without cribriform and intraductal carcinoma (CR/IDC) on biopsy. Methods Preoperative biopsies from 657 men undergoing radical prostatectomy (RP) for prostate cancer were reviewed for GG, presence of CR/IDC, percentage Gleason pattern 4, and tumor length. In men with biopsy GG2 without CR/IDC (n = 196), clinicopathologic features were compared between those with GG1 or GG2 without CR/IDC on RP (GG ≤ 2−) and those with GG2 with CR/IDC or any GG > 2 (GG ≥ 2+). Logistic regression analysis was used to predict upgrading in the biopsy cohort. Results In total 283 men had biopsy GG2 of whom 87 (30.7%) had CR/IDC and 196 (69.3%) did not. CR/IDC status in matched biopsy and RP specimens was concordant in 179 (63.3%) and discordant in 79 (27.9%) cases (sensitivity 45.1%; specificity 92.6%). Of 196 biopsy GG2 men without CR/IDC, 106 (54.1%) had GG ≥ 2+ on RP. Multivariable logistic regression analysis showed that age [odds ratio (OR): 1.85, 95% confidence interval (CI)1.09–3.20; p = 0.025], percentage Gleason pattern 4 (OR 1.54, 95% CI 1.17–2.07; p = 0.003), PI-RADS 5 lesion (OR 2.17, 95% CI 1.03–4.70; p = 0.045) and clinical stage T3 (OR 3.60; 95% CI 1.08–14.50; p = 0.049) were independent parameters to predict upgrading to GG ≥ 2+ on RP in these men. Conclusions Age, clinical stage T3, percentage Gleason pattern 4 and presence of PI-RADS 5 lesions are independent predictors for upgrading in men with biopsy GG2 without CR/IDC. These findings allow for improved clinical decision-making on surveillance eligibility in intermediate-risk prostate cancer patients.
Databáze: OpenAIRE
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