Abstract
Objectives: Gleason score 4+3 prostate cancer is associated with worse clinicopathologic outcomes than is Gleason score 3+4. Whether the increased risk associated with Gleason score 4+3 disease is equivalent to that of Gleason score 4+4 or greater is unclear. Methods: We reviewed the data from two separate cohorts pulled from the Shared Equal Access Regional Cancer Hospital database. The first consisted of 374 men with biopsy Gleason score 3+4 or greater disease and the second of 636 men with radical prostatectomy (RP) Gleason score 3+4 or greater disease. We estimated the odds ratios of unfavorable surgical pathologic findings for the biopsy Gleason score categories using logistic regression analysis. Using a Cox proportional hazards regression model, we estimated the relative risk of biochemical progression associated with each biopsy and RP Gleason score category. Results: In the biopsy Gleason score cohort, a Gleason score of 4+3 was associated with an increased risk of extracapsular extension (P = 0.01) and seminal vesicle invasion (P <0.001) relative to a biopsy Gleason score of 3+4. A biopsy Gleason score of 4+3 was associated with a similar risk of adverse pathologic findings relative to a biopsy Gleason score of 4+4 or greater (all P >0.10), except for higher grade pathologic tumors among men with a biopsy Gleason score of 4+4 or more (P = 0.001). After adjusting for multiple clinical characteristics, a biopsy Gleason score of 4+3 was associated with an increased recurrence risk relative to a biopsy Gleason score of 3+4 (P = 0.001), but a similar progression risk as that for a biopsy Gleason score of 4+4 or more (P = 0.53). In the RP Gleason cohort, and after adjustment for multiple clinicopathologic features, an RP Gleason score of 4+3 was associated with increased progression risk relative to an RP Gleason score of 3+4 (P = 0.03), but similar progression risk as that for an RP Gleason score of 4+4 or more (P = 0.24). Conclusions: In a multicenter database using pooled data from multiple pathologists, Gleason scores 4+3 and 4+4 or more exhibited similar clinicopathologic outcomes.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 277-282 |
| Number of pages | 6 |
| Journal | Urology |
| Volume | 70 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 1 2007 |
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ASJC Scopus subject areas
- Urology
Cite this
Risk Stratification of Men with Gleason Score 7 to 10 Tumors by Primary and Secondary Gleason Score : Results from the SEARCH Database. / Kang, David E.; Fitzsimons, Nicholas J.; Presti, Joseph C.; Kane, Christopher J.; Terris, Martha K.; Aronson, William J.; Amling, Christopher L.; Freedland, Stephen J.
In: Urology, Vol. 70, No. 2, 01.08.2007, p. 277-282.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk Stratification of Men with Gleason Score 7 to 10 Tumors by Primary and Secondary Gleason Score
T2 - Results from the SEARCH Database
AU - Kang, David E.
AU - Fitzsimons, Nicholas J.
AU - Presti, Joseph C.
AU - Kane, Christopher J.
AU - Terris, Martha K.
AU - Aronson, William J.
AU - Amling, Christopher L.
AU - Freedland, Stephen J.
PY - 2007/8/1
Y1 - 2007/8/1
N2 - Objectives: Gleason score 4+3 prostate cancer is associated with worse clinicopathologic outcomes than is Gleason score 3+4. Whether the increased risk associated with Gleason score 4+3 disease is equivalent to that of Gleason score 4+4 or greater is unclear. Methods: We reviewed the data from two separate cohorts pulled from the Shared Equal Access Regional Cancer Hospital database. The first consisted of 374 men with biopsy Gleason score 3+4 or greater disease and the second of 636 men with radical prostatectomy (RP) Gleason score 3+4 or greater disease. We estimated the odds ratios of unfavorable surgical pathologic findings for the biopsy Gleason score categories using logistic regression analysis. Using a Cox proportional hazards regression model, we estimated the relative risk of biochemical progression associated with each biopsy and RP Gleason score category. Results: In the biopsy Gleason score cohort, a Gleason score of 4+3 was associated with an increased risk of extracapsular extension (P = 0.01) and seminal vesicle invasion (P <0.001) relative to a biopsy Gleason score of 3+4. A biopsy Gleason score of 4+3 was associated with a similar risk of adverse pathologic findings relative to a biopsy Gleason score of 4+4 or greater (all P >0.10), except for higher grade pathologic tumors among men with a biopsy Gleason score of 4+4 or more (P = 0.001). After adjusting for multiple clinical characteristics, a biopsy Gleason score of 4+3 was associated with an increased recurrence risk relative to a biopsy Gleason score of 3+4 (P = 0.001), but a similar progression risk as that for a biopsy Gleason score of 4+4 or more (P = 0.53). In the RP Gleason cohort, and after adjustment for multiple clinicopathologic features, an RP Gleason score of 4+3 was associated with increased progression risk relative to an RP Gleason score of 3+4 (P = 0.03), but similar progression risk as that for an RP Gleason score of 4+4 or more (P = 0.24). Conclusions: In a multicenter database using pooled data from multiple pathologists, Gleason scores 4+3 and 4+4 or more exhibited similar clinicopathologic outcomes.
AB - Objectives: Gleason score 4+3 prostate cancer is associated with worse clinicopathologic outcomes than is Gleason score 3+4. Whether the increased risk associated with Gleason score 4+3 disease is equivalent to that of Gleason score 4+4 or greater is unclear. Methods: We reviewed the data from two separate cohorts pulled from the Shared Equal Access Regional Cancer Hospital database. The first consisted of 374 men with biopsy Gleason score 3+4 or greater disease and the second of 636 men with radical prostatectomy (RP) Gleason score 3+4 or greater disease. We estimated the odds ratios of unfavorable surgical pathologic findings for the biopsy Gleason score categories using logistic regression analysis. Using a Cox proportional hazards regression model, we estimated the relative risk of biochemical progression associated with each biopsy and RP Gleason score category. Results: In the biopsy Gleason score cohort, a Gleason score of 4+3 was associated with an increased risk of extracapsular extension (P = 0.01) and seminal vesicle invasion (P <0.001) relative to a biopsy Gleason score of 3+4. A biopsy Gleason score of 4+3 was associated with a similar risk of adverse pathologic findings relative to a biopsy Gleason score of 4+4 or greater (all P >0.10), except for higher grade pathologic tumors among men with a biopsy Gleason score of 4+4 or more (P = 0.001). After adjusting for multiple clinical characteristics, a biopsy Gleason score of 4+3 was associated with an increased recurrence risk relative to a biopsy Gleason score of 3+4 (P = 0.001), but a similar progression risk as that for a biopsy Gleason score of 4+4 or more (P = 0.53). In the RP Gleason cohort, and after adjustment for multiple clinicopathologic features, an RP Gleason score of 4+3 was associated with increased progression risk relative to an RP Gleason score of 3+4 (P = 0.03), but similar progression risk as that for an RP Gleason score of 4+4 or more (P = 0.24). Conclusions: In a multicenter database using pooled data from multiple pathologists, Gleason scores 4+3 and 4+4 or more exhibited similar clinicopathologic outcomes.
UR - http://www.scopus.com/inward/record.url?scp=34548461739&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34548461739&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2007.03.059
DO - 10.1016/j.urology.2007.03.059
M3 - Article
C2 - 17826489
AN - SCOPUS:34548461739
VL - 70
SP - 277
EP - 282
JO - Urology
JF - Urology
SN - 0090-4295
IS - 2
ER -