You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2012195 THE QUANTITATIVE GLEASON SCORE IMPROVES THE PREDICTION OF BIOCHEMICAL PROSTATE CANCER RECURRENCE AFTER RADICAL PROSTATECTOMY IN MEN WITH GLEASON 7 DISEASE Adam Reese, Janet Cowan, Jonathan Brajtbord, Catherine Harris, Peter Carroll, and Matthew Cooperberg Adam ReeseAdam Reese Baltimore, MD More articles by this author , Janet CowanJanet Cowan San Francisco, CA More articles by this author , Jonathan BrajtbordJonathan Brajtbord San Francisco, CA More articles by this author , Catherine HarrisCatherine Harris San Francisco, CA More articles by this author , Peter CarrollPeter Carroll San Francisco, CA More articles by this author , and Matthew CooperbergMatthew Cooperberg San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.247AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The pathologic Gleason score is strongly associated with biochemical recurrence (BCR) after radical prostatectomy (RP). However, the current categorical Gleason system groups a wide range of patients with varying disease risks into relatively few Gleason categories. We propose the quantitative Gleason score (qGS), a continuous scoring system based on the weighted average of Gleason patterns present in a pathology specimen. We hypothesized that this qGS can improve predictions of BCR after RP. METHODS We developed the qGS, a modification of the current Gleason system based on the weighted average of Gleason patterns present in the pathology specimen. We applied this modified system to all men with Gleason 7 tumors after RP in our institutional prostate cancer database. Using decision curve and Cox proportional hazards regression, we assessed the ability of the qGS to predict the risk of BCR after RP. RESULTS 618 patients met our inclusion criteria. Using dichotomous Gleason scoring, 451 (73%) were pathological Gleason 3+4 and 167 (27%) were 4+3. The continuous nature of the qGS enabled finer categorization of risk according to extent of Gleason pattern 4 disease (see figure 1). 78 men (12.6%) developed BCR within 4 years. On multivariable analysis, the qGS was significantly associated with BCR (HR 1.13, 95% CI 1.04 – 1.24). The c-index for the qGS model exceeded that of the traditional Gleason model (0.74 vs 0.72). In a model incorporating both the quantitative and traditional Gleason scores, the quantitative model was associated with BCR (p < 0.01), whereas the traditional Gleason score was not (p = 0.91). A decision curve illustrating the net benefit of quantitative compared to traditional Gleason scoring is shown in figure 2. CONCLUSIONS The quantitative Gleason score of RP specimens is strongly associated with BCR, and appears to be a better predictor of BCR than the traditional, dichotomous Gleason grading system. The qGS may allow for more precise risk stratification in men with prostate cancer. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e81-e82 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adam Reese Baltimore, MD More articles by this author Janet Cowan San Francisco, CA More articles by this author Jonathan Brajtbord San Francisco, CA More articles by this author Catherine Harris San Francisco, CA More articles by this author Peter Carroll San Francisco, CA More articles by this author Matthew Cooperberg San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...