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Favorable intermediate risk prostate cancer with biopsy Gleason score of 6

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Authors
Oh, Jong Jin; Ahn, Hyungwoo; Hwang, Sung Il; Lee, Hak Jong; Choe, Gheeyoung; Lee, Sangchul; Lee, Hakmin; Byun, Seok-Soo; Hong, Sung Kyu
Issue Date
2021-04-05
Publisher
BMC
Citation
BMC Urology. 2021 Apr 05;21(1):52
Keywords
Prostate cancerIntermediate risk groupMRI
Abstract
Background
To identify potential prognostic factors among patients with favorable intermediate risk prostate cancer with a biopsy Gleason score 6.

Methods
From 2003 to 2019, favorable intermediate risk patients who underwent radical prostatectomy were included in this study. All patients were evaluated preoperatively with MRI. Using PI-RADS scores, patients were divided into two groups, and clinic-pathological outcomes were compared. The impact of preoperative factors on significant pathologic Gleason score upgrading (≥ 4 + 3) and biochemical recurrence were assessed via multivariate analysis. Subgroup analysis was performed in patients with PI-RADS ≤ 2.

Results
Among the 239 patients, 116 (48.5%) were MRI-negative (PI-RADS ≤ 3) and 123 (51.5%) were MRI-positive (PI-RADS > 3). Six patients in the MRI-negative group (5.2%) were characterized as requiring significant pathologic Gleason score upgrading compared with 34 patients (27.6%) in the MRI-positive group (p < 0.001). PI-RADS score was shown to be a significant predictor of significant pathologic Gleason score upgrading (OR = 6.246, p < 0.001) and biochemical recurrence (HR = 2.595, p = 0.043). 10-years biochemical recurrence-free survival was estimated to be 84.4% and 72.6% in the MRI-negative and MRI-positive groups (p = 0.035). In the 79 patients with PI-RADS ≤ 2, tumor length in biopsy cores was identified as a significant predictor of pathologic Gleason score (OR = 11.336, p = 0.014).

Conclusions
Among the patients with favorable intermediate risk prostate cancer with a biopsy Gleason score 6, preoperative MRI was capable of predicting significant pathologic Gleason score upgrading and biochemical recurrence. Especially, the patients with PI-RADS ≤ 2 and low biopsy tumor length could be a potential candidate to active surveillance.
ISSN
1471-2490
Language
English
URI
https://hdl.handle.net/10371/174634
DOI
https://doi.org/10.1186/s12894-021-00827-2
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College of Medicine/School of Medicine (의과대학/대학원)Urology (비뇨기과학전공)Journal Papers (저널논문_비뇨기과학전공)
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