Impact of primary Gleason grade on risk stratification for Gleason score 7 prostate cancers.

Published

Journal Article

PURPOSE: To evaluate the primary Gleason grade (GG) in Gleason score (GS) 7 prostate cancers for risk of non-organ-confined disease with the goal of optimizing radiotherapy treatment option counseling. METHODS: One thousand three hundred thirty-three patients with pathologic GS7 were identified in the Duke Prostate Center research database. Clinical factors including age, race, clinical stage, prostate-specific antigen at diagnosis, and pathologic stage were obtained. Data were stratified by prostate-specific antigen and clinical stage at diagnosis into adapted D'Amico risk groups. Univariate and multivariate analyses were performed evaluating for association of primary GG with pathologic outcome. RESULTS: Nine hundred seventy-nine patients had primary GG3 and 354 had GG4. On univariate analyses, GG4 was associated with an increased risk of non-organ-confined disease. On multivariate analysis, GG4 was independently associated with seminal vesicle invasion (SVI) but not extracapsular extension. Patients with otherwise low-risk disease and primary GG3 had a very low risk of SVI (4%). CONCLUSIONS: Primary GG4 in GS7 cancers is associated with increased risk of SVI compared with primary GG3. Otherwise low-risk patients with GS 3+4 have a very low risk of SVI and may be candidates for prostate-only radiotherapy modalities.

Full Text

Duke Authors

Cited Authors

  • Koontz, BF; Tsivian, M; Mouraviev, V; Sun, L; Vujaskovic, Z; Moul, J; Lee, WR

Published Date

  • January 1, 2012

Published In

Volume / Issue

  • 82 / 1

Start / End Page

  • 200 - 203

PubMed ID

  • 21237582

Pubmed Central ID

  • 21237582

Electronic International Standard Serial Number (EISSN)

  • 1879-355X

Digital Object Identifier (DOI)

  • 10.1016/j.ijrobp.2010.11.023

Language

  • eng

Conference Location

  • United States