Grade Group Underestimation in Prostate Biopsy: Predictive Factors and Outcomes in Candidates for Active Surveillance
| Autor: | Matthieu Resche-Rigon, Xavier Cathelineau, Dominique Prapotnich, Rafael Sanchez-Salas, Marc Galiano, François Rozet, François Audenet, Remy Bernard, Alexandre Ingels, Eric Barret |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Biochemical recurrence medicine.medical_specialty Prostate biopsy Urology medicine.medical_treatment 030232 urology & nephrology 03 medical and health sciences 0302 clinical medicine Risk Factors Biopsy medicine Humans Minimally Invasive Surgical Procedures Prospective Studies Prospective cohort study Aged Digital Rectal Examination Prostatectomy medicine.diagnostic_test business.industry Prostatic Neoplasms Rectal examination Middle Aged Prostate-Specific Antigen Nomogram Surgery Nomograms Prostate-specific antigen Logistic Models Oncology Population Surveillance 030220 oncology & carcinogenesis Neoplasm Grading business |
| Zdroj: | Clinical Genitourinary Cancer. 15:e907-e913 |
| ISSN: | 1558-7673 |
| DOI: | 10.1016/j.clgc.2017.04.024 |
| Popis: | We intended to analyze the outcomes and predictive factors for underestimating the prostate cancer (PCa) grade group (GG) from prostate biopsies in a large monocentric cohort of patients treated by minimally invasive radical prostatectomy (RP).Using a monocentric prospectively maintained database, we included 3062 patients who underwent minimally invasive RP between 2006 and 2013. We explored clinicopathologic features and outcomes associated with a GG upgrade from biopsy to RP. Multivariate logistic regression was used to develop and validate a nomogram to predict upgrading for GG1.Biopsy GG was upgraded after RP in 51.5% of cases. Patients upgraded from GG1 to GG2 or GG3 after RP had a longer time to biochemical recurrence than those with GG2 or GG3 respectively, on both biopsy and RP, but a shorter time to biochemical recurrence than those who remained GG1 after RP (P .0001). In multivariate analyses, variables predicting upgrading for GG1 PCa were age (P = .0014), abnormal digital rectal examination (P .0001), prostate-specific antigen density (P .0001), percentage of positive cores (P .0001), and body mass index (P = .037). A nomogram was generated and validated internally.Biopsy grading system is misleading in approximately 50% of cases. Upgrading GG from biopsy to RP may have consequences on clinical outcomes. A nomogram using clinicopathologic features could aid the probability of needing to upgrade GG1 patients at their initial evaluation. |
| Databáze: | OpenAIRE |
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