Gleason Pattern 5 is a Possible Pathologic Predictor for Biochemical Recurrence after Laparoscopic...

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Biochemical recurrence after radical prostatectomy is a significant concern.
• Established prognostic factors include PSA, Gleason score, surgical margin, and seminal vesicle invasion.
• The prognostic value of Gleason pattern 5, particularly as a tertiary pattern, remains underexplored.

Purpose of the Study:

• To investigate whether the presence of Gleason pattern 5 predicts biochemical recurrence after laparoscopic radical prostatectomy.
• To determine if Gleason pattern 5 is an independent prognostic factor for recurrence-free survival.

Main Methods:

• Retrospective study of 168 patients undergoing laparoscopic radical prostatectomy (2006-2015).
• Analysis of Gleason pattern 5 presence (primary, secondary, or tertiary) and its association with biochemical recurrence.
• Biochemical recurrence defined as PSA >0.2 ng/ml post-surgery.
• Kaplan-Meier and Cox proportional hazards regression analyses were used.

Main Results:

• Biochemical recurrence occurred in 16.1% of patients; 5-year recurrence-free survival was 78.6%.
• Gleason pattern 5 was present in 20 patients (primary, secondary, or tertiary).
• Multivariate analysis identified Gleason pattern 5 (HR=4.75, p=0.001) and positive surgical margin (HR=4.66, p=0.001) as independent predictors of recurrence-free survival.

Conclusions:

• Gleason pattern 5 is a significant independent predictor of biochemical recurrence following laparoscopic radical prostatectomy.
• The presence of Gleason pattern 5, even as a tertiary pattern, should be considered in risk stratification for prostate cancer patients.
• This finding may refine prognostic assessments and guide treatment decisions post-surgery.