Older Age Predicts Biopsy and Radical Prostatectomy Grade Reclassification to Aggressive Prostate Cancer in Men on Active Surveillance

Druskin, Sasha C.; Mamawala, Mufaddal; Tosoian, Jeffrey J.; Epstein, Jonathan I.; Pavlovich, Christian P.; Carter, H. Ballentine; Trock, Bruce J.

doi:10.1016/j.juro.2018.08.023

Cited by 23 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the older patients were reported to have more aggressive prostate cancer at diagnosis more frequently [3]. And age is also considered as a risk factor of pathological upgrading to higher risk disease after operation [4]. In older men with high-risk disease, the aggressive treatment with a 46 % reduction of mortality risk was reported comparing to treat conservatively [3].…”

Section: Discussionmentioning

confidence: 99%

Impact of GAS5 genetic polymorphism on prostate cancer susceptibility and clinicopathologic characteristics

Lin¹,

Wang²,

Yang³

et al. 2019

Int. J. Med. Sci.

View full text Add to dashboard Cite

Down-regulation of Growth arrest-specific 5 (GAS5) is correlated with enhanced cell proliferation and poorer prognosis of prostate cancer. We aimed to investigate the effect of variant rs145204276 of GAS5 on the prostate cancer susceptibility and clinicopathologic characteristics. In this study, 579 prostate cancer patients who underwent robot-assisted radical prostatectomy and 579 healthy controls were included. The frequency of the allele del of rs145204276 were compared between the patients and the controls to evaluate the impact of tumor susceptibility and the correlation of clinicopathological variables. The results shown that patients who carries genotype ins/del or del/del at SNP rs145204276 showed decreased risk of pathological lymph node metastasis disease (OR=0.545, p=0.043) and risk of seminal vesicle invasion (OR=0.632, p=0.022) comparing to with genotype ins/ins. In the subgroup analysis of age, more significant risk reduction effects were noted over lymph node metastasis disease (OR=0.426, p=0.032) and lymphovascular invasion (OR=0.521, p=0.025). In conclusion, the rs145204276 polymorphic genotype of GAS5 can predict the risk of lymph node metastasis. This is the first study to report the correlation between GAS5 gene polymorphism and prostate cancer prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of GAS5 genetic polymorphism on prostate cancer susceptibility and clinicopathologic characteristics

Lin¹,

Wang²,

Yang³

et al. 2019

Int. J. Med. Sci.

View full text Add to dashboard Cite

show abstract

“…20 Men aged >70 on active surveillance are also at increased risk of progression (n=1625). 21 In our own local audit of 500 TRUS results from 2010 to 2013, we found that approximately 70% of all high-grade cancer occurs in men >70. This perhaps explains why the European screening trial only reduced mortality by 20%.…”

Section: Discussionmentioning

confidence: 89%

Correlation of Likert scores III–V with increasingly worse pathology in radical prostatectomy specimens significant only for men aged <60 or PSAD >0.15, with age <60 as good as PSAD <0.15 at discriminating lower risk in Likert III

Ord

Crockett

Green

et al. 2021

Journal of Clinical Urology

View full text Add to dashboard Cite

Objectives: This study aimed to compare Likert scores with radical prostatectomy specimens. Methods: This study examined 443 men with validated pre-biopsy magnetic resonance imaging results and used cross-tabulation and chi-square significance testing with National Comprehensive Cancer Network risk categories. Results: The mean prostate-specific antigen (PSA) was 10, and the mean age was 64 years. Comparing Likert III to Likert V and Likert IV to Likert V, both (each p=0.02) were significantly associated with higher prostate cancer risk groups, but Likert III versus Likert IV was not ( p=0.1). Within the subgroup PSA density (PSAD) <0.15 ( n=140), the correlation of Likert score and final pathological risk group was lost ( p=0.5), but it was not lost within the subgroup PSAD >0.15 ( n=281; p=0.045 III vs. IV only and p=0.055 overall). Within the subgroup age <60 ( n=104), the correlation of Likert score and final pathological risk group was significant ( p=0.006 for III vs. IV and p=0.04 overall), whereas within the subgroup age >60 ( n=339) this significant difference was lost ( p=0.34). Further subgroup analysis within Likert III ( n=86) found that men <60 ( n=22) had neither high-grade (G3 or G4 or G5) nor very high-risk disease. There were only two high-risk cases, both of which were G2T3a (2/22; 10%). In men with Likert III and PSAD <0.15 ( n=31), there were seven high-risk and two very high-risk cases (9/31; 25%). This difference was not significant ( p=0.31) Conclusion: With these two findings, we recommend that men <60 with Likert III can be counselled like men with Likert III and PSAD <0.15, that they are unlikely to have unfavourable or high-risk disease and that they may wish to avoid biopsy or treatment. Level of evidence: Level 1b.

show abstract

“…Druskin et al (page 98) from Baltimore, Maryland evaluated a cohort of 1,625 men on active surveillance to determine the influence of patient age on reclassification to a Gleason score of Grade Group 3 or higher cancer. 8 The 5-year incidence of reclassification to Grade Group 3 or higher was 4%, 7% and 14% for ages less than 60 years, 60 to 69 years and 70 years or greater, respectively. The impact of age was retained on multivariable analysis.…”

Section: Age Predicts Grade Reclassification To Aggressive Prostate Cancermentioning

confidence: 90%

This Month in Adult Urology

Smith¹

2019

Journal of Urology

View full text Add to dashboard Cite

Focal therapy for prostate cancer has captured the imagination of patients and clinicians alike. Studies have convincingly shown that morbidity is less than with whole gland therapy which is in line with expectations. Less certain are the oncologic outcomes. It is going to be difficult to gain confidence in this aspect because of the relatively small number of patients included in most cohorts, variable entry criteria for use of focal therapy, differences in followup regimens and the prolonged natural history of the tumor in most patients who may be eligible for this therapy. Information is likely to emerge in snippets, and one such snippet is reported in this issue of The Journal.

show abstract

Older Age Predicts Biopsy and Radical Prostatectomy Grade Reclassification to Aggressive Prostate Cancer in Men on Active Surveillance

Abstract: For men on AS, older age at time of diagnosis was positively associated with BGR to GG≥3, and RPGR. These observations imply that for many older men, AS (as opposed to watchful waiting) remains a more appropriate management strategy.

Cited by 23 publications

References 0 publications

Impact of GAS5 genetic polymorphism on prostate cancer susceptibility and clinicopathologic characteristics

Impact of GAS5 genetic polymorphism on prostate cancer susceptibility and clinicopathologic characteristics

Correlation of Likert scores III–V with increasingly worse pathology in radical prostatectomy specimens significant only for men aged <60 or PSAD >0.15, with age <60 as good as PSAD <0.15 at discriminating lower risk in Likert III

This Month in Adult Urology

Contact Info

Product

Resources

About