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Author Spotlight: Advancing Prostate Cancer Research Through Improved Tissue Sampling and Biobanking
Published on: November 17, 2023
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Does the Gleason Score 7 Upgrading Always Predict Worse Prognosis?
Jiatong Zhou1, Minghao Yu1, Jie Ding1
1Department of Urology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Clinical Genitourinary Cancer
|May 29, 2023
Summary
Gleason score 7 upgrade after radical prostatectomy impacts prognosis, particularly in men with PSA 4.1-10ng/ml. This upgrade is a significant risk factor for overall survival in specific prostate cancer patient groups.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Gleason score (GS) is crucial for prostate cancer (PCa) grading.
- Upgrading of GS from biopsy to radical prostatectomy (RP) specimens can occur.
- The clinical significance of GS 7 upgrade on RP and its prognostic impact requires further elucidation.
Purpose of the Study:
- To determine the clinical significance of Gleason score 7 upgrade on radical prostatectomy.
- To investigate the impact of Gleason score upgrade on patient prognosis and overall survival (OS).
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database.
- Included 8832 men diagnosed with M0 prostate cancer (PCa) (GS 3+4/4+3) treated by RP (2010-2015).
- Employed logistic and Cox hazards regression analyses to assess factors influencing GS upgrade and OS.
Main Results:
- Identified prostate-specific antigen (PSA) >20ng/ml, T stage 3-4, and lymph node metastasis as independent risk factors for GS upgrade post-RP.
- Black race, GS upgrade, and chemotherapy were significant predictors of poor OS.
- Biopsy GS upgrade showed a significant association with poor OS in patients with PSA 0-4ng/ml and 4.1-10ng/ml.
Conclusions:
- Gleason score 7 upgrade on RP does not universally lead to a worse prognosis.
- Biopsy GS 7 upgrade is an independent risk factor for poor OS specifically in patients with PSA 4.1-10ng/ml.
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