What Are the Predictive Factors for Gleason Score Upgrade following RP?

Alchin, David Rhys; Murphy, Declan; Lawrentschuk, Nathan

doi:10.1159/000439139

Cited by 6 publications

(5 citation statements)

References 16 publications

(29 reference statements)

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“…In the literature, multiple clinical variables are reported to be predictive for GG discordance, where GG upgrade indicators include older age 20 , higher PSA 20 , lower prostate volume 28 , higher PSAD 28 , higher PI-RADS score 27 , and higher tumor percentage in biopsy cores 29 .…”

Section: Discussionmentioning

confidence: 99%

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology

Ozbozduman,

Loc,

Durmaz

et al. 2024

Sci Rep

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This study aimed to enhance the accuracy of Gleason grade group (GG) upgrade prediction in prostate cancer (PCa) patients who underwent MRI-guided in-bore biopsy (MRGB) and radical prostatectomy (RP) through a combined analysis of prebiopsy and MRGB clinical data. A retrospective analysis of 95 patients with prostate cancer diagnosed by MRGB was conducted where all patients had undergone RP. Among the patients, 64.2% had consistent GG results between in-bore biopsies and RP, whereas 28.4% had upgraded and 7.4% had downgraded results. GG1 biopsy results, lower biopsy core count, and fewer positive cores were correlated with upgrades in the entire patient group. In patients with $$\hbox {GG}>1$$ GG > 1 , larger tumor sizes and fewer biopsy cores were associated with upgrades. By integrating MRGB data with prebiopsy clinical data, machine learning (ML) models achieved 85.6% accuracy in predicting upgrades, surpassing the 64.2% baseline from MRGB alone. ML analysis also highlighted the value of the minimum apparent diffusion coefficient ($$\hbox {ADC}_{\text{min}}$$ ADC min ) for $$\hbox {GG}>1$$ GG > 1 patients. Incorporation of MRGB results with tumor size, $$\hbox {ADC}_{\text{min}}$$ ADC min value, number of biopsy cores, positive core count, and Gleason grade can be useful to predict GG upgrade at final pathology and guide patient selection for active surveillance.

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Section: Discussionmentioning

confidence: 99%

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology

Ozbozduman,

Loc,

Durmaz

et al. 2024

Sci Rep

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“…In addition to our study, in these studies, positivity rate in biopsy, PSA density, obesity, and smoking in risk groups for GS upgrade were also investigated. [20] Table 2. Clinicopathological characteristics of the study groups Yoo et al [21] conducted a study on 1582 patients.…”

Section: Discussionmentioning

confidence: 99%

The Value of Gleason Score Upgrade in Predicting Biochemical Recurrence After Radical Prostatectomy

Yildiz¹

2021

bogazicitip

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Objectives: In this study, we aimed to investigate the effect of the Gleason score (GS) increase in the radical prostatectomy (RP) specimen compared to prostate biopsy material on predicting biochemical recurrence (BCR).Methods: A total of 201 patients who underwent RP between 2012 and 2018 were included in the study. Patients were assigned to three groups: Upgrade, downgrade, and no change in GSs. These groups were compared in terms of positive surgical margins (PSMs) and BCR.Results: There was no statistically significant difference between the groups according to age and pre-biopsy prostate-specific antigen. BCR rate was significantly higher in the upgrade group, while there was no significant difference in PSMs. The main limitation of our study was its short follow-up period. Conclusion:Numerous studies have been conducted to predict biochemical relapse after RP. This study demonstrates that pathological upgrade may be useful as an independent predictor of recurrence.

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“…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).…”

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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

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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...

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What Are the Predictive Factors for Gleason Score Upgrade following RP?

Cited by 6 publications

References 16 publications

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology

The Value of Gleason Score Upgrade in Predicting Biochemical Recurrence After Radical Prostatectomy

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

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