MP79-12 CLINICAL SIGNIFICANCE OF PERCENTAGE OF GLEASON PATTERN 4 IN GLEASON SCORE 7 PROSTATE CANCER AT RADICAL PROSTATECTOMY (2016)

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2016MP79-12 CLINICAL SIGNIFICANCE OF PERCENTAGE OF GLEASON PATTERN 4 IN GLEASON SCORE 7 PROSTATE CANCER AT RADICAL PROSTATECTOMY Mohsin Jamal, Sean R. Williamson, Mireya Diaz-Insua, Mani Menon, Hans Stricker, James Peabody, Craig Rogers, and Nilesh Gupta Mohsin JamalMohsin Jamal More articles by this author , Sean R. WilliamsonSean R. Williamson More articles by this author , Mireya Diaz-InsuaMireya Diaz-Insua More articles by this author , Mani MenonMani Menon More articles by this author , Hans StrickerHans Stricker More articles by this author , James PeabodyJames Peabody More articles by this author , Craig RogersCraig Rogers More articles by this author , and Nilesh GuptaNilesh Gupta More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We sought to determine the prognostic value of percentage Gleason pattern 4 in radical prostatectomy specimens. METHODS We selected 400 patients who underwent robotic radical prostatectomy (RRP) between 2010 and 2011 with Gleason score 7. Data collected included pT stage, tumor volume, margin status, angiolymphatic invasion, lymph node involvement and biochemical recurrence (BCR) at 2 years after surgery. RESULTS Mean age of the patients was 62 years. We stratified the patients into four quartiles based on percentage of Gleason pattern 4 (GP4). Q1: percent of Gleason 4 <=20, Q2: >20% - 35%, Q3: >35% - 65%, Q4: >65%. Table 1 shows these quartiles correlated with multiple pathological outcomes. Percentage of GP4 was associated with BCR when other pathologic features were accounted for. A percent greater than 65 (i.e. fourth quartile) was significantly different from a percent of 20 or less in providing a greater likelihood for recurrence OR=6.53 (95% CI 2.43, 17.56). The other factors that were also significant were margins, positive lymph nodes and angiolymphatic invasion. These four variables yielded a c-statistic of 0.82. If percentage of GP4 is considered as a continuous measure, it is also independently related with PSA recurrence within 2 years of surgery. A unit increase in the percent of GP4 increases the likelihood of recurrence by 3 percent, OR=1.03 (1.01, 1.04). CONCLUSIONS 1. Gleason 7 prostatic adenocarcinoma represents a heterogenous group of tumors. A subgroup of tumors with Gleason score 3+4=7 and low percentage of GP4 (<=20%) carry favorable prognosis compared to Gleason score 3+4=7 tumors with higher percentage (>20%) of pattern 4. 2. Percentage of GP4 is an important parameter that should be reported on all radical prostatectomies with Gleason score 7, given its independent prognostic value. 3. Additional studies are needed to determine the role of higher Gleason pattern percentages in tumors other than Gleason score 7. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1039 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Mohsin Jamal More articles by this author Sean R. Williamson More articles by this author Mireya Diaz-Insua More articles by this author Mani Menon More articles by this author Hans Stricker More articles by this author James Peabody More articles by this author Craig Rogers More articles by this author Nilesh Gupta More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...