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Patients with Biopsy Gleason 9 and 10 Prostate Cancer Have Significantly Worse Outcomes Compared to Patients with Gleason 8 Disease.

Publication ,  Journal Article
Tsao, C-K; Gray, KP; Nakabayashi, M; Evan, C; Kantoff, PW; Huang, J; Galsky, MD; Pomerantz, M; Oh, WK
Published in: J Urol
July 2015

PURPOSE: We examined differences in outcome in patients with biopsy Gleason score 8 vs 9-10 who received definitive local therapy. MATERIALS AND METHODS: Using an institutional database we identified a cohort of 847 patients with biopsy Gleason 8-10 disease who received definitive local therapy with radiation therapy or radical prostatectomy between January 2001 and December 2011. Multivariable Cox modeling was used to assess the association of Gleason score 8 vs 9-10 with time to biochemical recurrence, metastasis and overall survival, and evaluate treatment by Gleason score interaction. Median followup in the cohort was 5.3 years. RESULTS: Baseline patient characteristics were similar for biopsy Gleason 8 vs 9-10. Gleason 9-10 disease was associated with higher prostate specific antigen at diagnosis. As local treatment such patients were also more likely to have received radiation therapy (58% vs 46%, p = 0.001) and neoadjuvant/adjuvant androgen deprivation therapy (64% vs 49%, p <0.001). Those with higher grade disease were at increased risk for metastasis (HR 1.41, 95% CI 1.11-1.79). There was a trend toward an increased risk of death in Gleason 9-10 vs 8 cases (HR 1.28, 95% CI 0.98-1.66). The increased risk of death for Gleason 9-10 was mainly observed in patients treated with radical prostatectomy with or without additional radiation therapy (HR 1.74, 95% CI 1.15-2.65). CONCLUSIONS: Patients with localized biopsy Gleason 9-10 disease treated with definitive local therapy had worse outcomes than those diagnosed with biopsy Gleason 8 disease. Clinical trials are urgently needed that incorporate newer approaches to Gleason 9-10 cancer.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

July 2015

Volume

194

Issue

1

Start / End Page

91 / 97

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prognosis
  • Neoplasm Grading
  • Male
  • Humans
  • Adenocarcinoma
  • 3202 Clinical sciences
 

Citation

APA
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ICMJE
MLA
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Tsao, C.-K., Gray, K. P., Nakabayashi, M., Evan, C., Kantoff, P. W., Huang, J., … Oh, W. K. (2015). Patients with Biopsy Gleason 9 and 10 Prostate Cancer Have Significantly Worse Outcomes Compared to Patients with Gleason 8 Disease. J Urol, 194(1), 91–97. https://doi.org/10.1016/j.juro.2015.01.078
Tsao, Che-Kai, Kathryn P. Gray, Mari Nakabayashi, Carolyn Evan, Philip W. Kantoff, Jiaoti Huang, Matthew D. Galsky, Mark Pomerantz, and William K. Oh. “Patients with Biopsy Gleason 9 and 10 Prostate Cancer Have Significantly Worse Outcomes Compared to Patients with Gleason 8 Disease.J Urol 194, no. 1 (July 2015): 91–97. https://doi.org/10.1016/j.juro.2015.01.078.
Tsao C-K, Gray KP, Nakabayashi M, Evan C, Kantoff PW, Huang J, et al. Patients with Biopsy Gleason 9 and 10 Prostate Cancer Have Significantly Worse Outcomes Compared to Patients with Gleason 8 Disease. J Urol. 2015 Jul;194(1):91–7.
Tsao, Che-Kai, et al. “Patients with Biopsy Gleason 9 and 10 Prostate Cancer Have Significantly Worse Outcomes Compared to Patients with Gleason 8 Disease.J Urol, vol. 194, no. 1, July 2015, pp. 91–97. Pubmed, doi:10.1016/j.juro.2015.01.078.
Tsao C-K, Gray KP, Nakabayashi M, Evan C, Kantoff PW, Huang J, Galsky MD, Pomerantz M, Oh WK. Patients with Biopsy Gleason 9 and 10 Prostate Cancer Have Significantly Worse Outcomes Compared to Patients with Gleason 8 Disease. J Urol. 2015 Jul;194(1):91–97.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

July 2015

Volume

194

Issue

1

Start / End Page

91 / 97

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prognosis
  • Neoplasm Grading
  • Male
  • Humans
  • Adenocarcinoma
  • 3202 Clinical sciences