OncoTargets and Therapy (Sep 2019)

Significance of tertiary Gleason pattern 5 in patients with Gleason score 7 after radical prostatectomy: a retrospective cohort study

  • Li J,
  • Guo Y,
  • Qiu S,
  • He M,
  • Jin K,
  • Zheng X,
  • Tu X,
  • Liao X,
  • Yang L,
  • Wei Q

Journal volume & issue
Vol. Volume 12
pp. 7157 – 7164

Abstract

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Jiakun Li,1 Yaochuan Guo,2 Shi Qiu,1 Mingjing He,1 Kun Jin,1 Xiaonan Zheng,1 Xiang Tu,1 Xinyang Liao,1 Lu Yang,1 Qiang Wei11Department of Urology, Institute of Urology, Center of Biomedical Bid Data and National Clinical Research Center of Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Urology, Chongqing Three Gorges Central Hospital, Chongqing 404000, People’s Republic of ChinaCorrespondence: Lu YangDepartment of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan 610041, People’s Republic of ChinaTel +86 1 354 123 5213Email [email protected] WeiDepartment of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan 610041, People’s Republic of ChinaTel +86 1 898 060 1425Email [email protected]: To evaluate the association between tertiary Gleason pattern 5 (TGP5) and biochemical recurrence (BCR) in patients with prostate cancer (PCa) with a Gleason score (GS) of 7 after radical prostatectomy (RP).Patients and methods: This retrospective study identified 350 patients who received RP and were graded as GS 7 (3+4 or 4+3) at the West China Hospital from January 2009 to December 2017. Initially, the patients were divided into two groups, TGP5 absence and TGP5 presence, independent of Gleason score. We further stratified the patients by adding the Gleason score into four groups: GS 3+4, GS 3+4/TGP5, GS 4+3, and GS 4+3/TGP5. Cox proportional-hazards models were used to evaluate the association between the status of TGP5 and BCR after adjusting for the confounding factors.Results: The risk of BCR was significantly higher in patients with TGP5 when compared to patients without TGP5 (P=0.04, HR=2.17 95%, Cl: 1.03–4.59). For patients with primary Gleason pattern 4, the risk of BCR for patients with Gleason 4+3/TGP5 was statistically significantly higher than Gleason 4+3 (P=0.04, HR=2.45, 95% Cl: 1.04–5.76).Conclusion: The TGP5 in patients with GS 7 had strong association with the risk of BCR and was an independent predictor for BCR. Further research on larger data sets is needed to confirm these findings.Keywords: prostate cancer, biochemical recurrence, Gleason score, tertiary Gleason pattern, radical prostatectomy

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