PD19-12 MODIFIED GLEASON GRADE OF PROSTATIC ADENOCARCINOMAS DETECTED IN THE PROSTATE, LUNG, COLORECTAL, AND OVARIAN CANCER SCREENING TRIAL

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening I1 Apr 2014PD19-12 MODIFIED GLEASON GRADE OF PROSTATIC ADENOCARCINOMAS DETECTED IN THE PROSTATE, LUNG, COLORECTAL, AND OVARIAN CANCER SCREENING TRIAL Peter Humphrey, Marshall Strother, Robert Grubb, Thomas Hickey, Mary Korch, Thomas Riley, Jerome Mabie, Adam Bellinger, and Gerald Andriole Peter HumphreyPeter Humphrey More articles by this author , Marshall StrotherMarshall Strother More articles by this author , Robert GrubbRobert Grubb More articles by this author , Thomas HickeyThomas Hickey More articles by this author , Mary KorchMary Korch More articles by this author , Thomas RileyThomas Riley More articles by this author , Jerome MabieJerome Mabie More articles by this author , Adam BellingerAdam Bellinger More articles by this author , and Gerald AndrioleGerald Andriole More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1531AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The aim of this investigation was to determine modified Gleason histologic grade of adenocarcinomas of the prostate detected in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial in order to assess the grade distribution and to compare the modified Gleason grades of cancers detected in the intervention arm (organized annual screening) vs. those in the control arm (opportunistic screening). Methods A total of 859 radical prostatectomies from the years 1994 to 2006 had histologic slides available for review, including 693 specimens from the screened arm and 166 from the control arm. Modified Gleason grading was performed by a single urologic pathologist using the 2005 International Society of Urological Pathology modified Gleason grading system. During tissue banking, control arm specimens were deliberately chosen to over-represent higher grade disease, so a correction factor was applied to estimate the true proportion of modified Gleason grades in the overall control prostatectomy population. The proportions of samples with high grade disease (modified Gleason score of 7 or greater) in the control and intervention arms were compared. Results A modified Gleason score of 5, 6, 7(3+4), 7(4+3), 8, 9, and 10 was assigned in 3.6%, 43.3%, 39%, 7.4%, 3.5%, 3.2%, and 0.1% of cases in the intervention arm and 3.0%, 35.7%, 46.4%, 7.1%, 5.4%, 1.9%, and 0.5% of cases in the corrected control arm, respectively. High grade disease (Gleason score 7-10) was detected in 53% of the radical prostatectomy samples from the intervention arm compared to 61.3% of samples from the corrected control arm (p =0.019). The median modified Gleason score of adenocarcinomas was 7 (3+4) in both the intervention and the control arms. Conclusions A significant percentage of screen-detected cancers in both arms had a component of high grade disease, with a slight majority of cases in the intervention arm having a modified Gleason score of 7 or greater. The modified Gleason grade of the prostate cancers detected by organized annual screening was slightly lower than the modified Gleason grade of prostate cancers detected by opportunistic screening, an expected consequence of more intensive screening. Control Intervention N Raw % Corrected % N Raw % Corrected % All 166 100 100 693 100 100 Modified Gleason Score 5 4 2.41 3.00 25 3.61 3.61 6 51 30.72 35.70 300 43.29 43.29 7: 3+4 72 43.37 46.35 270 38.96 38.96 7: 4+3 17 10.24 7.13 51 7.36 7.36 8 12 7.23 5.42 24 3.46 3.46 9 8 4.82 1.91 22 3.17 3.17 10 2 1.20 0.48 1 0.14 0.14 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e550 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Peter Humphrey More articles by this author Marshall Strother More articles by this author Robert Grubb More articles by this author Thomas Hickey More articles by this author Mary Korch More articles by this author Thomas Riley More articles by this author Jerome Mabie More articles by this author Adam Bellinger More articles by this author Gerald Andriole More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...