A Single Microfocus (5% or Less) of Gleason 6 Prostate Cancer at Biopsy—Can We Predict Adverse Pathological Outcomes?
2008; Lippincott Williams & Wilkins; Volume: 180; Issue: 6 Linguagem: Inglês
10.1016/j.juro.2008.08.027
ISSN1527-3792
AutoresAlan Thong, Sergey Shikanov, Mark H. Katz, Ofer N. Gofrit, Scott E. Eggener, Gregory P. Zagaja, Arieh L. Shalhav, Kevin C. Zorn,
Tópico(s)Urologic and reproductive health conditions
ResumoNo AccessJournal of UrologyAdult Urology1 Dec 2008A Single Microfocus (5% or Less) of Gleason 6 Prostate Cancer at Biopsy—Can We Predict Adverse Pathological Outcomes?is accompanied byEffect of IN-1130, a Small Molecule Inhibitor of Transforming Growth Factor-β Type I Receptor/Activin Receptor-Like Kinase-5, on Prostate Cancer Cells Alan E. Thong, Sergey Shikanov, Mark H. Katz, Ofer N. Gofrit, Scott Eggener, Gregory P. Zagaja, Arieh L. Shalhav, and Kevin C. Zorn Alan E. ThongAlan E. Thong , Sergey ShikanovSergey Shikanov , Mark H. KatzMark H. Katz , Ofer N. GofritOfer N. Gofrit , Scott EggenerScott Eggener , Gregory P. ZagajaGregory P. Zagaja , Arieh L. ShalhavArieh L. Shalhav , and Kevin C. ZornKevin C. Zorn View All Author Informationhttps://doi.org/10.1016/j.juro.2008.08.027AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Patients with Gleason score 6 microfocal prostate cancer, defined as 5% or less in 1 biopsy core, are often considered to have favorable disease. Few studies have addressed clinical parameters that predict pathological upgrading or up staging at radical prostatectomy. Materials and Methods: From a prospective database of 1,271 consecutive robot assisted laparoscopic prostatectomies performed from 2003 to 2008 patients with Gleason score 6 microfocal prostate cancer were identified. Adverse pathological outcome was defined as any upgrading and/or up staging on prostatectomy pathological findings. Multivariate logistic regression was used to evaluate the ability of patient age, clinical stage, the total number of biopsy cores, preoperative prostate specific antigen, prostate volume and pathological prostate specific antigen density to predict adverse pathological outcomes. Results: A total of 192 patients with a median age of 59 years (range 42 to 73) were identified with Gleason score 6 prostate cancer involving 5% or less of 1 biopsy core, including 177 (92%) with clinical T1c disease. Mean ± SD preoperative prostate specific antigen was 6.0 ± 3.9 ng/ml (range 0.8 to 35). Overall 42 patients (22%) had adverse pathological outcomes, including upgrading in 35 (18%) and up staging in 16 (8%). Multivariate logistic regression revealed that age more than 65 years and pathological prostate specific antigen density greater than 0.20 ng/ml/gm were predictive of an increased risk of adverse pathological results (p = 0.0081 and 0.0169, respectively). Conclusions: While a microfocus of Gleason score 6 prostate cancer on biopsy is commonly considered low risk disease, there was a greater than 1/5 risk of pathological upgrading and/or up staging. Patients with Gleason score 6 microfocal prostate cancer should be counseled that they may harbor more aggressive disease, especially when pretreatment clinical risk factors are present, such as advanced age or high clinical prostate specific antigen density. References 1 : Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA1993; 270: 948. Crossref, Medline, Google Scholar 2 : The contemporary management of prostate cancer in the United States: lesions from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), a national disease registry. J Urol2004; 171: 1393. 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Google Scholar Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byEggener S, Badani K, Barocas D, Barrisford G, Cheng J, Chin A, Corcoran A, Epstein J, George A, Gupta G, Hayn M, Kauffman E, Lane B, Liss M, Mirza M, Morgan T, Moses K, Nepple K, Preston M, Rais-Bahrami S, Resnick M, Siddiqui M, Silberstein J, Singer E, Sonn G, Sprenkle P, Stratton K, Taylor J, Tomaszewski J, Tollefson M, Vickers A, White W and Lowrance W (2015) Gleason 6 Prostate Cancer: Translating Biology into Population HealthJournal of Urology, VOL. 194, NO. 3, (626-634), Online publication date: 1-Sep-2015.Related articlesJournal of Urology24 Oct 2008Effect of IN-1130, a Small Molecule Inhibitor of Transforming Growth Factor-β Type I Receptor/Activin Receptor-Like Kinase-5, on Prostate Cancer Cells Volume 180Issue 6December 2008Page: 2436-2440 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsprostatic neoplasmsprognosisbiopsyprostateprostatectomyMetrics Author Information Alan E. Thong More articles by this author Sergey Shikanov More articles by this author Mark H. Katz More articles by this author Ofer N. Gofrit Financial interest and/or other relationship with Biocancell. More articles by this author Scott Eggener More articles by this author Gregory P. Zagaja More articles by this author Arieh L. Shalhav More articles by this author Kevin C. Zorn More articles by this author Expand All Advertisement PDF downloadLoading ...
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