Korean J Urol.  2012 Dec;53(12):826-829. 10.4111/kju.2012.53.12.826.

Biochemical Recurrence in Gleason Score 7 Prostate Cancer in Korean Men: Significance of the Primary Gleason Grade

• Ro YK
• Lee S
• Jeong CW
• Hong SK
• Byun SS
• Lee SE

• KMID: 1988726
• DOI: http://doi.org/10.4111/kju.2012.53.12.826

Abstract

PURPOSE
To evaluate the impact of primary Gleason grade in Gleason score (GS) 7 prostate cancer on biochemical recurrence (BCR) after radical prostatectomy in Korean men.
MATERIALS AND METHODS
We retrospectively reviewed records of 1,026 patients who underwent radical prostatectomy at Seoul National University Bundang Hospital between November 2003 and June 2009. We excluded patients who had received neoadjuvant therapy and had positive resection margins. Finally, 295 and 113 patients with GS 3+4 and GS 4+3, respectively, were included in this study. All patients were followed for at least 2 years.
RESULTS
Of the 408 GS 7 patients, 295 (72.3%) were 3+4 and 113 (27.7%) were 4+3. Mean serum prostate specific antigen level in primary Gleason 3 was 8.99 ng/ml and primary Gleason 4 was 11.11 ng/ml. Patients with GS 4+3 were more likely to have extracapsular extension (30.1% vs. 17.6%, p<0.010) and lymphatic invasion (16.8% vs. 7.1%, p<0.005). After 2 years follow up BCR was detected in a total of 40 patients. In GS 7 with primary Gleason 3, BCR occurred in 15 (5.08%) patients while 20 (17.70%) showed BCR in GS 7 with primary Gleason 4.
CONCLUSIONS
In this study of a large, single center cohort of Korean men with GS 7 prostate cancer a noticeable difference in BCR was seen. Primary Gleason grade 4 have a higher risk of BCR compared to primary Gleason grade 3. This information may be useful when counseling patients on their prognosis and further management options.

Keyword

Biopsy; Prostate; Prostatectomy

MeSH Terms

Biopsy
Cohort Studies
Counseling
Follow-Up Studies
Humans
Male
Neoadjuvant Therapy
Neoplasm Grading
Prognosis
Prostate
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms
Recurrence
Retrospective Studies
Prostate-Specific Antigen

Figure

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  FIG. 1 Biochemical recurrence-free survival in men with Gleason score 3+4 and 4+3.

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