In:
Urologia Internationalis, S. Karger AG, Vol. 104, No. 3-4 ( 2020), p. 199-204
Abstract:
〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 The aim of this study was to evaluate the feasibility of including patients with biopsy Gleason score (bGS) 3 + 4 prostate cancer in an active surveillance (AS) protocol. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 615 patients underwent a radical prostatectomy and satisfied the following requirements: prostate-specific antigen ≤10 ng/dL, clinical stage T1c or T2a, 2 or fewer positive biopsy cores, and bGS 6 or 3 + 4 prostate cancer. The patients were divided into two groups according to their bGS (bGS 6 group, 〈 i 〉 n = 〈 /i 〉 534; bGS 3 + 4 group, 〈 i 〉 n 〈 /i 〉 = 81). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The adverse pathological features were significantly higher in the bGS 3 + 4 group (16.7 vs. 49.4%, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). Biochemical recurrence (BCR)-free survival was also significantly lower in this group ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). In a multivariate analysis, clinical stage (odds ratio [OR] 2.026, 〈 i 〉 p = 〈 /i 〉 0.007), maximum percentage of biopsy core involvement (OR 1.015, 〈 i 〉 p 〈 /i 〉 = 0.014), and bGS (OR 1.913, 〈 i 〉 p 〈 /i 〉 = 0.030) were independent risk factors for adverse pathological features. However, the bGS was the only variable to forecast BCR (hazard ratio 3.567, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 A bGS 3 + 4 was the leading risk factor for a worse postoperative prognosis. Therefore, patients with a bGS 3 + 4 are not appropriate candidates for AS.
Type of Medium:
Online Resource
ISSN:
0042-1138
,
1423-0399
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
1464417-4
