Correlation between trans rectal ultrasound guided prostate biopsy and radical prostatectomy specimen and risk factors for upgraded Gleason score in prostate cancer

Authors

  • Aekgarin Palakho Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Apirak Santi-ngamkun Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Julin Opanuraks Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Kavirach Tantiwongse Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Supoj Ratchanon Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Kamol Panumatrassamee Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Prostate cancer, Gleason score, upgraded, radical prostatectomy

Abstract

Background: Gleason score is an important pathologic factor for risk stratification in prostate cancer. Upgraded Gleason score is not uncommon after radical prostatectomy.

Objectives: This study aimed to investigate the prevalence of upgraded Gleason scores between trans rectal ultrasound guided prostate biopsy (TRUS-biopsy) and radical prostatectomy (RP) specimen and to determine the predictive factors for increased Gleason scores.

Methods: We retrospectively reviewed the medical records of prostate cancer patients who underwent RP from June 2006 – June 2016 at King Chulalongkorn Memorial Hospital (KCMH). Gleason scores from TRUS-biopsy and RP were compared. Pre-operative clinical parameters were analyzed to determine the risk factors of upgraded Gleason scores between the group of patients with increased Gleason scores and those with no increased Gleason scores.

Results: In all, 33% (68/204) of patients had upgraded Gleason scores after RP. Patients with upgraded Gleason scores had significantly lower ages (P = 0.02), higher PSA levels (P = 0.01) and longer durations from TRUS-biopsy to RP (P = 0.047). Patients’ age gif.latex?\leq 65 years, PSA gif.latex?\geq 10 ng/mL and duration from TRUS-biopsy to RP gif.latex?\geq 6 months were statistically significant factors for increased Gleason scores in both univariate and multivariate analysis.

Conclusions: The prevalence of upgraded Gleason scores is 33%. Patients’ age gif.latex?\leq 65 years, PSA gif.latex?\geq 10 ng/ml and duration from TRUS-biopsy to RP gif.latex?\geq 6 months are predictors for upgrading Gleason scores after surgery. These results provide clinical implications for the treatment planning of patients with a risk of upgraded prostate cancer.

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References

Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin 2014;64:9-29.

https://doi.org/10.3322/caac.21208

Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL. The 2005 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma. Am J Surg Pathol 2005;29:1228-42. https://doi.org/10.1097/01.pas.0000173646.99337.b1

Li XD, Qu GY, Xu N, Xue XY, Wei Y, Zheng QS, et al. Risk factors of ISUP Modified Gleason score upgrading after radical prostatectomy. Zhonghua Nan Ke Xue 2016;22: 415-9.

Moon SJ, Park SY, Lee TY. Predictive factors of Gleason score upgrading in localized and locally advanced prostate cancer diagnosed by prostate biopsy. Korean J Urol 2010;51:677-82.

https://doi.org/10.4111/kju.2010.51.10.677

Pereira RA, Costa RS, Muglia VF, Silva FF, Lajes JS, Dos Reis RB, et al. Gleason score and tumor laterality in radical prostatectomy and transrectal ultrasoundguided biopsy of the prostate: a comparative study. Asian J Androl 2015;17:815-20. https://doi.org/10.4103/1008-682X.146970

Gershman B, Dahl DM, Olumi AF, Young RH, McDougal WS, Wu CL. Smaller prostate gland size and older age predict Gleason score upgrading. Urol Oncol 2013;31:1033-7.

https://doi.org/10.1016/j.urolonc.2011.11.032

He B, Chen R, Gao X, Ren S, Yang B, Hou J, et al. Nomograms for predicting Gleason upgrading in a contemporary Chinese cohort receiving radical prostatectomy after extended prostate biopsy: development and internal validation. Oncotarget 2016;7:17275-85.

https://doi.org/10.18632/oncotarget.7787

Sfoungaristos S, Perimenis P. Clinical and pathological variables that predict changes in tumour grade after radical prostatectomy in patients with prostate cancer. Can Urol Assoc J 2013;7:E93-7.

https://doi.org/10.5489/cuaj.270

Tilki D, Schlenker B, John M, Buchner A, Stanislaus P, Gratzke C, et al. Clinical and pathologic predictors of Gleason sum upgrading in patients after radical prostatectomy: results from a single institution series. Urol Oncol 2011;29:508-14. https://doi.org/10.1016/j.urolonc.2009.07.003

Zuo Q, Zhang F, Huang Y, Ma LL, Lu M, Lu J. Clinically predictive factors of Gleason score upgrading in patients after radical prostatectomy. Beijing Da Xue Xue Bao 2016;48:603-6.

Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010;17:1471-4.

https://doi.org/10.1245/s10434-010-0985-4

Hernandez DJ, Nielsen ME, Han M, Partin AW. Contemporary evaluation of the D'amico risk classification of prostate cancer. Urology 2007;70: 931-5. https://doi.org/10.1016/j.urology.2007.08.055

Richstone L, Bianco FJ, Shah HH, Kattan MW, Eastham JA, Scardio PT, et al. Radical prostatectomy in men aged >or=70 years: effect of age on upgrading, upstaging, and the accuracy of a preoperative nomogram. BJU Int 2008;101:541-6. https://doi.org/10.1111/j.1464-410X.2007.07410.x

Salinas CA, Tsodikov A, Ishak-Howard M, Cooney KA. Prostate cancer in young men: an important clinical entity. Nat Rev Urol 2014;11:317-23. https://doi.org/10.1038/nrurol.2014.91

Dong F, Jones JS, Stephenson AJ, Magi-Galluzzi C, Reuther AM, Klein EA. Prostate cancer volume at biopsy predicts clinically significant upgrading. J Urol 2008;179:896-900.

https://doi.org/10.1016/j.juro.2007.10.060

Nayyar R, Singh P, Gupta NP, Hemal AK, Dogra PN, Seth A, et al. Upgrading of Gleason score on radical prostatectomy specimen compared to the pre-operative needle core biopsy: an Indian experience. Indian J Urol 2010;26:56-9. https://doi.org/10.4103/0970-1591.60445

Eroglu M, Doluoglu OG, Sarici H, Telli O, Ozgur BC, Bozkurt S. Does the time from biopsy to radical prostatectomy affect Gleason score upgrading in patients with clinical t1c prostate cancer? Korean J Urol 2014;55:395-9. https://doi.org/10.4111/kju.2014.55.6.395

Evans SM, Patabendi Bandarage V, Kronborg C, Earnest A, Millar J, Clouston D. Gleason group concordance between biopsy and radical prostatectomy specimens: A cohort study from Prostate Cancer Outcome Registry - Victoria. Prostate Int 2016;4:145-51. https://doi.org/10.1016/j.prnil.2016.07.004

Kvale R, Moller B, Wahlqvist R, Fossa SD, Bemer A, Busch C, et al. Concordance between Gleason scores of needle biopsies and radical prostatectomy specimens: a population-based study. BJU Int 2009;103:1647-54. https://doi.org/10.1111/j.1464-410X.2008.08255.x

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Published

2023-08-15

How to Cite

1.
Palakho A, Santi-ngamkun A, Opanuraks J, Tantiwongse K, Ratchanon S, Panumatrassamee K. Correlation between trans rectal ultrasound guided prostate biopsy and radical prostatectomy specimen and risk factors for upgraded Gleason score in prostate cancer. Chula Med J [Internet]. 2023 Aug. 15 [cited 2024 May 20];63(3). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/291

Issue

Vol. 63 No. 3 (2019): Chulalongkorn Medical Journal

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Original Articles

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