Abstract
15 Background: This retrospective study was conducted to better evaluate the impact of tertiary Gleason pattern 5 (TP5) on tumor pathological features and biochemical recurrence following radical prostatectomy (RP). Methods: We retrospectively reviewed 1,965 patients who underwent RP for clinically localized prostate cancer; TP5 was reported in 159 cases (8.1%). Men with Gleason score (GS) 7 and GS 8 disease were divided into two subgroups, with and without TP5, and histopathologic features were compared. Multivariate analyses and Kaplan-Meier curves were conducted to assess the impact on TP5 on biochemical-free survival (BFS). Results: Tumors possessing GS 3 + 4 with TP5 were significantly more likely to exhibit extraprostatic extension (EPE) and have a larger tumor diameter (TD) than GS 3 + 4 alone. GS 3 + 4 with TP5 was also associated with positive surgical margins (SM), seminal vesicle involvement (SVI), and higher pre-operative PSA values, but without statistical significance. GS 4 + 3 with TP5 more commonly presented with EPE, positive SM, SVI, and greater TD and PSA than GS 4 + 3 alone, with significance. In multivariate analysis, TP5 was shown to be an independent risk factor for PSA recurrence (Table). Additionally, GS 4 + 3 with TP5 was associated with shorter time to recurrence versus GS 4 + 3 alone. Conclusions: Our results emphasize the importance of high-grade tertiary patterns and suggest that criteria for tertiary pattern reporting in prostate cancer should be standardized. In addition, further studies are needed to evaluate the role of tertiary patterns in prognostic models. [Table: see text]
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call