The factors impacting on Gleason score upgrading in prostate cancer with initial low Gleason scores
Background: This study aims to investigate the factors contributing to the discrepancy in between biopsy Gleason score (GS) and radical prostatectomy GS in patients diagnosed with prostate cancer. Methods: 341 patients who underwent radical prostatectomy from 2011/04 to 2020/12 were identified. 102...
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Elsevier
2025-02-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S092966462400175X |
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| author | Tzu-Heng Huang Wei-Ming Li Hung-Lung Ke Ching-Chia Li Wen-Jeng Wu Hsin-Chih Yeh Yen-Chun Wang Hsiang-Ying Lee |
| author_facet | Tzu-Heng Huang Wei-Ming Li Hung-Lung Ke Ching-Chia Li Wen-Jeng Wu Hsin-Chih Yeh Yen-Chun Wang Hsiang-Ying Lee |
| author_sort | Tzu-Heng Huang |
| collection | DOAJ |
| description | Background: This study aims to investigate the factors contributing to the discrepancy in between biopsy Gleason score (GS) and radical prostatectomy GS in patients diagnosed with prostate cancer. Methods: 341 patients who underwent radical prostatectomy from 2011/04 to 2020/12 were identified. 102 Patients with initial GS of six after biopsy were enrolled. Preoperative clinical variables and pathological variables were also obtained and assessed. The optimal cut-off points for significant continuous variables were identified by the area under the receiver operating characteristic curve. Results: Upgrading was observed in 63 patients and non-upgrading in 39 patients. In the multiple variables assessed, smaller prostate volume (PV) (p value = 0.0007), prostate specific antigen density (PSAD) (p value = 0.0055), positive surgical margins (p value = 0.0062) and pathological perineural invasion (p value = 0.0038) were significant predictors of GS upgrading. To further explore preclinical variables, a cut-off value for PV (≤ 38 ml, p value = 0.0017) and PSAD (≥ 0.26 ng/ml2, p value = 0.0013) were identified to be associated with GS upgrading. Conclusion: Smaller PV and elevated PSAD are associated with increased risk of GS upgrading, whereas lead-time bias is not. A cut-off value of PV < 38 ml and PSAD > 0.26 ng/ml2 were further identified to be associated with pathological GS upgrading. |
| format | Article |
| id | doaj-art-59cfa9a89ed84a68b89e2e4bd2cd95c2 |
| institution | Kabale University |
| issn | 0929-6646 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj-art-59cfa9a89ed84a68b89e2e4bd2cd95c22025-02-02T05:26:45ZengElsevierJournal of the Formosan Medical Association0929-66462025-02-011242145150The factors impacting on Gleason score upgrading in prostate cancer with initial low Gleason scoresTzu-Heng Huang0Wei-Ming Li1Hung-Lung Ke2Ching-Chia Li3Wen-Jeng Wu4Hsin-Chih Yeh5Yen-Chun Wang6Hsiang-Ying Lee7Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833401, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Urology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, 90054, Taiwan; Cohort Research Center, Kaohsiung Medical University, Kaohsiung, 80708, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, 80145, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Cohort Research Center, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, 80145, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan; Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Corresponding author. Address: No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung, 80708, Taiwan.Background: This study aims to investigate the factors contributing to the discrepancy in between biopsy Gleason score (GS) and radical prostatectomy GS in patients diagnosed with prostate cancer. Methods: 341 patients who underwent radical prostatectomy from 2011/04 to 2020/12 were identified. 102 Patients with initial GS of six after biopsy were enrolled. Preoperative clinical variables and pathological variables were also obtained and assessed. The optimal cut-off points for significant continuous variables were identified by the area under the receiver operating characteristic curve. Results: Upgrading was observed in 63 patients and non-upgrading in 39 patients. In the multiple variables assessed, smaller prostate volume (PV) (p value = 0.0007), prostate specific antigen density (PSAD) (p value = 0.0055), positive surgical margins (p value = 0.0062) and pathological perineural invasion (p value = 0.0038) were significant predictors of GS upgrading. To further explore preclinical variables, a cut-off value for PV (≤ 38 ml, p value = 0.0017) and PSAD (≥ 0.26 ng/ml2, p value = 0.0013) were identified to be associated with GS upgrading. Conclusion: Smaller PV and elevated PSAD are associated with increased risk of GS upgrading, whereas lead-time bias is not. A cut-off value of PV < 38 ml and PSAD > 0.26 ng/ml2 were further identified to be associated with pathological GS upgrading.http://www.sciencedirect.com/science/article/pii/S092966462400175XProstate biopsyProstate cancerProstate volume |
| spellingShingle | Tzu-Heng Huang Wei-Ming Li Hung-Lung Ke Ching-Chia Li Wen-Jeng Wu Hsin-Chih Yeh Yen-Chun Wang Hsiang-Ying Lee The factors impacting on Gleason score upgrading in prostate cancer with initial low Gleason scores Journal of the Formosan Medical Association Prostate biopsy Prostate cancer Prostate volume |
| title | The factors impacting on Gleason score upgrading in prostate cancer with initial low Gleason scores |
| title_full | The factors impacting on Gleason score upgrading in prostate cancer with initial low Gleason scores |
| title_fullStr | The factors impacting on Gleason score upgrading in prostate cancer with initial low Gleason scores |
| title_full_unstemmed | The factors impacting on Gleason score upgrading in prostate cancer with initial low Gleason scores |
| title_short | The factors impacting on Gleason score upgrading in prostate cancer with initial low Gleason scores |
| title_sort | factors impacting on gleason score upgrading in prostate cancer with initial low gleason scores |
| topic | Prostate biopsy Prostate cancer Prostate volume |
| url | http://www.sciencedirect.com/science/article/pii/S092966462400175X |
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