Details

Autor(en) / Beteiligte

• Kweldam, Charlotte F
• Kümmerlin, Intan P
• Nieboer, Daan
• Verhoef, Esther I
• Steyerberg, Ewout W
• Incrocci, Luca
• Bangma, Chris H
• van der Kwast, Theodorus H
• Roobol, Monique J
• van Leenders, Geert J

Titel

Prostate cancer outcomes of men with biopsy Gleason score 6 and 7 without cribriform or intraductal carcinoma

Ist Teil von

• European journal of cancer (1990), 2016-10, Vol.66, p.26-33

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2016

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Aim of the study Gleason score (GS) 3 + 4 = 7 prostate cancer patients with presence of cribriform or intraductal carcinoma (7+ ) have a worse disease-specific survival than those without. The aim of this study was to compare the clinicopathologic characteristics and patient outcomes of men with biopsy GS 3 + 4 = 7 without cribriform or intraductal carcinoma (7– ) to those with GS 3 + 3 = 6. Materials and methods We included all patients from the first screening round of the European Randomized Study of Screening for Prostate Cancer (1993–2000) with a revised GS ≤ 3 + 4 = 7 (n = 796) following the 2014 International Society of Urological Pathology criteria. Relations with biochemical recurrence after radical prostatectomy or radiotherapy were analysed using log-rank testing and multivariable Cox regression analysis. Results In total, 486 patients had GS 6 and 310 had GS 7, 54 of whom had GS 7+ (17%). During a median follow-up of 15 years, biochemical recurrence was seen in 61 (20%) GS 6, 54 (21%) GS 7– and 22 (41%) GS 7+ patients (41%). Both biopsy GS 7– and 7+ patients had significantly higher prostate-specific antigen levels, mean tumour percentage, percentage of positive cores and ≥cT3 than those with GS 6 (all P < .001). GS 7– patients did not have a poorer biochemical recurrence-free survival (BCRFS) after radical prostatectomy than GS 6 patients (log-rank P = .13), whereas those with GS 7+ had (log-rank P = .05). In multivariable analyses, biopsy GS 7– was not associated with poorer BCRFS after radical prostatectomy (hazard ratio [HR], 1.3; 95% confidence interval [CI]: 0.67–2.4; P = .47) or radiotherapy (HR, 0.88; 95% CI: 0.51–1.5; P = .63). GS 7+ was independently associated with poorer BCRFS after radical prostatectomy (HR, 3.0; 95% CI: 1.1–7.8; P = .03), but not after radiotherapy (HR, 1.2; 95% CI: 0.58–2.3; P = .67). Conclusions Men with biopsy GS 7– prostate cancer have similar BCRFS after radical prostatectomy or radiotherapy to those with GS 6 and may be candidates for active surveillance as long as other inclusion criteria such as on PSA and tumour volume are met.