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Factors predicting Gleason score 6 upgrading after radical prostatectomy.

Milonas D, Grybas A, Auskalnis S, Gudinaviciene I, Baltrimavicius R, Kincius M, Jievaltas M - Cent European J Urol (2011)

Bottom Line: Gleason score upgrade was found in 92 of 241 patients (38.2%).Gleason score upgrading was observed to be accompanied by significantly higher rates of extra prostatic extension (p <0.001) and seminal vesicle invasion (p = 0.002).Upgraded tumors significantly associated with adverse pathological features.

View Article: PubMed Central - PubMed

Affiliation: Lithuanian Health Science University, Department of Urology, Kaunas, Lithuania.

ABSTRACT

Objectives: Prostate cancer Gleason score 6 is the most common score detected on prostatic biopsy. We analyzed the clinical parameters that predict the likelihood of Gleason score upgrading after radical prostatectomy.

Methods: The study population consisted of 241 patients who underwent radical retropubic prostatectomy between Feb 2002 and Dec 2007 for Gleason score 6 adenocarcinoma. The influence of preoperative parameters on the probability of a Gleason score upgrading after surgery was evaluated using multivariate logistic regression and ROC curves.

Results: Gleason score upgrade was found in 92 of 241 patients (38.2%). Multivariate logistic regression analysis showed that only percentage of cancer in dominant lobe and prostate weight were significant predictors for Gleason score upgrading (p = 0.043 and p = 0.006, respectively). ROC curves showed that prostate weight and PSA density were only two independent significant parameters for prediction of upgrade (AUC - 0.634, p <0.0001 and 0.604, p = 0.006, respectively). Gleason score upgrading was observed to be accompanied by significantly higher rates of extra prostatic extension (p <0.001) and seminal vesicle invasion (p = 0.002).

Conclusions: Almost forty percent of tumors graded Gleason 6 at biopsy are Gleason 7 at surgery. Upgraded tumors significantly associated with adverse pathological features. The probability of Gleason score upgrade can be predicted using prostate weight and PSA density as independent parameters.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristics (ROC) curves of prostate weight and PSA density for predicting Gleason score upgrading.
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Figure 0001: Receiver operating characteristics (ROC) curves of prostate weight and PSA density for predicting Gleason score upgrading.

Mentions: As for assessing the predictive role of observed predictors for upgrading, the ROC curves were constructed. Prostate weight and PSA density (AUC 0.634, p <0.0001 and 0.604, p = 0.006 respectively) were only two significant parameters (Fig. 1). The cut-off level for significant parameters was 47.5 gr. (prostate weight) and 0.135 (PSA density) with 60% sensitivity and specificity.


Factors predicting Gleason score 6 upgrading after radical prostatectomy.

Milonas D, Grybas A, Auskalnis S, Gudinaviciene I, Baltrimavicius R, Kincius M, Jievaltas M - Cent European J Urol (2011)

Receiver operating characteristics (ROC) curves of prostate weight and PSA density for predicting Gleason score upgrading.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921736&req=5

Figure 0001: Receiver operating characteristics (ROC) curves of prostate weight and PSA density for predicting Gleason score upgrading.
Mentions: As for assessing the predictive role of observed predictors for upgrading, the ROC curves were constructed. Prostate weight and PSA density (AUC 0.634, p <0.0001 and 0.604, p = 0.006 respectively) were only two significant parameters (Fig. 1). The cut-off level for significant parameters was 47.5 gr. (prostate weight) and 0.135 (PSA density) with 60% sensitivity and specificity.

Bottom Line: Gleason score upgrade was found in 92 of 241 patients (38.2%).Gleason score upgrading was observed to be accompanied by significantly higher rates of extra prostatic extension (p <0.001) and seminal vesicle invasion (p = 0.002).Upgraded tumors significantly associated with adverse pathological features.

View Article: PubMed Central - PubMed

Affiliation: Lithuanian Health Science University, Department of Urology, Kaunas, Lithuania.

ABSTRACT

Objectives: Prostate cancer Gleason score 6 is the most common score detected on prostatic biopsy. We analyzed the clinical parameters that predict the likelihood of Gleason score upgrading after radical prostatectomy.

Methods: The study population consisted of 241 patients who underwent radical retropubic prostatectomy between Feb 2002 and Dec 2007 for Gleason score 6 adenocarcinoma. The influence of preoperative parameters on the probability of a Gleason score upgrading after surgery was evaluated using multivariate logistic regression and ROC curves.

Results: Gleason score upgrade was found in 92 of 241 patients (38.2%). Multivariate logistic regression analysis showed that only percentage of cancer in dominant lobe and prostate weight were significant predictors for Gleason score upgrading (p = 0.043 and p = 0.006, respectively). ROC curves showed that prostate weight and PSA density were only two independent significant parameters for prediction of upgrade (AUC - 0.634, p <0.0001 and 0.604, p = 0.006, respectively). Gleason score upgrading was observed to be accompanied by significantly higher rates of extra prostatic extension (p <0.001) and seminal vesicle invasion (p = 0.002).

Conclusions: Almost forty percent of tumors graded Gleason 6 at biopsy are Gleason 7 at surgery. Upgraded tumors significantly associated with adverse pathological features. The probability of Gleason score upgrade can be predicted using prostate weight and PSA density as independent parameters.

No MeSH data available.


Related in: MedlinePlus