How significant is upgrade in Gleason score between prostate biopsy and radical prostatectomy pathology while discussing less invasive treatment options?

Süer, Evren; Gökçe, Mehmet İlker; Gülpınar, Ömer; Güçlü, Adil Güçal; Haciyev, Perviz; Göğüş, Çağatay; Türkölmez, Kadír; Baltacı, Sümer

doi:10.3109/21681805.2013.829519

Cited by 17 publications

(12 citation statements)

References 23 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Regarding upgrade in Gleason score, Suer et al [12] found that an upgrade in Gleason score between biopsy and radical prostatectomy specimen occurred in 29% of cases compared to our results of 48% (47/98). Furthermore, another retrospective study found that overall 35% of the patients had an upgraded Gleason score after radical prostatectomy [13].…”

Section: Discussioncontrasting

confidence: 86%

Are TRUS-guided prostate biopsies in clinical practice robust enough to make a correct assessment of the surgical strategy in prostatectomies? Poor correlation between preoperative prostate biopsies and postoperative specimens

Nilsson

Ströberg

2019

Scandinavian Journal of Urology

View full text Add to dashboard Cite

Objective: TRUS-guided prostatic biopsies are the mainstay procedure to diagnose prostatic cancer. The aim was to investigate how accurate and reliable these biopsies are by comparing them with the final pathology results after prostatectomy. Materials and methods: One hundred consecutive patients diagnosed with localized prostatic cancer using this technique and who subsequently underwent a radical prostatectomy in V€ asterbotten County were included in this study. From the pathological-anatomical diagnosis (PAD) of core needle biopsies, data was extracted on the location of the tumour within the prostate, the tumour volume and the Gleason score, and compared with the characteristics of the prostatectomy specimen. The frequency and type of deviation between the pre-operative and post-operative examinations was recorded. Results: In 95% of the cases there was a poor correlation between the pre-operative and post-operative pathological reports. In the final report, 48% had a higher Gleason score and 88% had deviations in localization when compared with the information from the biopsies. If known prior to surgery, a total of 104 of these deviations might have had a significant impact on the surgical strategy. Conclusions: The pre-operative biopsies in this setting rarely match the final prostate PAD results (5%). The most common deviations were in localization and in Gleason score, where the majority consisted of a higher Gleason score and/or tumour presence in a previously unknown location. This information, if known prior to surgery, might have altered the treatment strategy and ultimately the outcome of the treatment.

show abstract

Section: Discussioncontrasting

confidence: 86%

Are TRUS-guided prostate biopsies in clinical practice robust enough to make a correct assessment of the surgical strategy in prostatectomies? Poor correlation between preoperative prostate biopsies and postoperative specimens

Nilsson

Ströberg

2019

Scandinavian Journal of Urology

View full text Add to dashboard Cite

show abstract

“…This may explain, in part, the difference in upgrading rates in 3+3 vs. 3+4 disease. Poor concordance rates have been described in the prostate cancer literature 11,26 and the lack of a central pathologic review in SEER data is a limit to this discussion. We also were unable to evaluate prostate gland volume, PSA density, the percent of core involvement, or the length of cores taken, all of which have been described as prognostic and may have added further clarification to this analysis.…”

Section: Discussionmentioning

confidence: 94%

“…4 These limitations are further suggested by the significant number of patients (25-60%) upgraded at the time of radical prostatectomy (RP). [5][6][7][8][9][10][11][12][13] Therefore, an improved understanding of the clinical factors associated with occult aggressive disease is needed to better inform treatment recommendations.…”

Section: Introductionmentioning

confidence: 99%

“…Towards this goal, many have evaluated factors associated with Gleason upgrading at the time of RP [5][6][7][8][9][10][11][12][13] however, the significance of upgrading at RP can be difficult to interpret clinically, as all upgrading may not be equal. For instance, the clinical significance of upgrading from Gleason grade 3+3 to Gleason 3+4 disease with small % pattern 4 disease can be debated, while data suggests Gleason 4+3 (primary pattern 4) compared to 3+4 may be associated with increased lethality.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Extreme Gleason Upgrading From Biopsy to Radical Prostatectomy: A Population-based Analysis

Winters

Wright

Holt

et al. 2016

Urology

View full text Add to dashboard Cite

“…Fakat diğer faktörlerin de önemini koruduğunu söyleyebiliriz. GS'de yükselme gözlenen hastalarda biyokimyasal nüks oranının yüksek olması nedeniyle GS'deki artışı öngören tüm faktörlerin tam anlamıyla aydınlatılması önem arz etmektedir (26,27). Ayrıca PİB GS'yi değerlendiren patoloğun da belli bir tecrübeyle dikkatli değerlendirmesinin önemli etkenlerden biri olduğu belirtilmektedir, bu bakış açısı ile yapılan bir araştırmada üropatolog tarafınca değerlendirilen hastalardaki derece yükselmesinin diğer gruba göre daha düşük oranda saptandığı vurgulanmaktadır (28).…”

Section: Discussionunclassified

Preoperative Factors Related to Stage and Grade Increase in D’Amico Low-Risk and Intermediate-Risk Group Patients

Çelik¹,

Bozkurt²,

Demir³

et al. 2016

uob

View full text Add to dashboard Cite

Objective: In this study we searched preoperative factors that may cause upstaging and upgrading at D'Amico low-risk and intermediate-risk group patients who underwent radical prostatectomy (RRP) due to prostate adenocarcinoma. Materials and Methods: Among patients undergoing RRP retrospective evaluation, those who have PSA<10ng/mL, prostate needle biopsy (PNB) Gleason score (GS) ≤6 and clinical T1c-T2a were placed in the low-risk group. Patients with PSA 10-20 ng/mL and/or PNB GS=7 and/or clinical T2b were placed in the intermediate-risk group. In accordance with PNB GS and clinical stage, patients whose RRP GS and T stage increased or not with PNB GS 3+4=7 (7a) and RRP GS 4+3=7 (7b) were assessed as upgrade. The PSA data, PNB and RRP pathological data and biochemical recurrence rates of patients were investigated. Current data were used to separately assess and compare low-risk and intermediate-risk groups according to upstaging and upgrading. Results: Among the 151 patients in the low-risk group, it was identified that 21 had upstage and 63 had upgrade, while in the 187 patients in the intermediaterisk group 84 had upstage and 39 had upgrade. In the low-risk group, the PNB tumor percentage was identified to be high in the upgrade group (p<0.001). In the intermediate-risk group, PSA, PSA density, PNB perineural invasion (PNI) positivity, tumor percentage and positive core numbers were high in the upstage group. However, in the intermediate-risk group PSA, fPSA, PSA density, PNB GS and tumor percentage were high in the upgrade group (p<0.05). When postoperative factors were examined, tumor volume and surgical margin positivity were observed to be correlated with upstaging and upgrading. Conclusion: In conclusion, in the low-risk group PNB tumor percentage was related to upgrading, in the intermediate-risk group, PSA, PSA density and PNB tumor percentage were correlated with both upstaging and upgrading, while PNB PNI positivity and positive core numbers were observed to be correlated with T stage increase only. Keywords: D'Amico risk classification, low-risk and intermediate-risk prostate cancer, prostate needle biopsy, upgrading, upstaging Amaç: Bu yazıda kliniğimizde prostat adenokarsinomu nedenli radikal retropubik prostatektomi (RRP) yapılan D'Amico düşük-risk ve orta-risk grubundaki hastalarda evre ve derece yükselmesine neden olabilecek preoperatif faktörler araştırıldı. Gereç ve Yöntem: RRP yapılan hastalardan prostat spesifik antijen (PSA) <10 ng/mL ve prostat iğne biyopsisi (PİB) Gleason skoru (GS) ≤6 ve klinik T1c-T2a olan hastalar D'Amico düşük-risk grubunda; PSA 10-20 ng/mL ve/veya PİB GS=7 ve/veya klinik T2b olan hastalar D'Amico orta-risk grubunda değerlendirildi. PİB GS ve klinik evresine göre RRP GS ve T evresinde yükselme olan ve olmayan hastalarda, PİB GS ve klinik evresine göre RRP GS ve T evresinde yükselme olan ve olmayan hastalar araştırıldı, bununla birlikte PİB GS 3+4=7 (7a) olup da RRP GS 4+3=7 (7b) olanlar da derecede yükselme olarak değerlendirildi. Hastaların PSA verileri, PİB ve RRP...

show abstract

How significant is upgrade in Gleason score between prostate biopsy and radical prostatectomy pathology while discussing less invasive treatment options?

Cited by 17 publications

References 23 publications

Are TRUS-guided prostate biopsies in clinical practice robust enough to make a correct assessment of the surgical strategy in prostatectomies? Poor correlation between preoperative prostate biopsies and postoperative specimens

Are TRUS-guided prostate biopsies in clinical practice robust enough to make a correct assessment of the surgical strategy in prostatectomies? Poor correlation between preoperative prostate biopsies and postoperative specimens

Extreme Gleason Upgrading From Biopsy to Radical Prostatectomy: A Population-based Analysis

Preoperative Factors Related to Stage and Grade Increase in D’Amico Low-Risk and Intermediate-Risk Group Patients

Contact Info

Product

Resources

About