Pathological Features Of Prostate Cancer Research Articles

Association between ABO blood group and unfavorable prostate cancer features after radical prostatectomy: Retrospective study of 1149 patients.

To test hypothesized associations between the ABO blood group (ABO-bg) system and the pathological features of prostate cancer (PCa). Between January 2013 and September 2019, 1173 patients underwent radical prostatectomy. Associations between ABO-bg levels and pathological features were evaluated using statistical methods. Overall, 1149 consecutive patients were evaluated using the ABO-bg system, which was represented by O-bg (42.8%) and A-bg (41.3%), followed by B-bg (11.1%) and AB-bg (4.8%). Only positive surgical margins (PSMs) was correlated with ABO-bg (Pearson correlation coefficient, r = 0.071; p = 0.017), and the risk was increased in group-O (odds ratio [OR], 1.497; 95% confidence interval, 1.149-1.950; p = 0.003) versus non-O-bg. In clinical and pathological models, O-bg was at increased risk of PSM after the adjustment for prostate-specific antigen, percentage of biopsy-positive cores, and high surgical volume (adjusted OR, 1.546; 95% confidence interval, 1.180-2.026; p = 0.002); however, the adjusted OR did not change after the adjustment for tumor load and stage as well as high surgical volume. In clinical PCa, the risk of PSM was higher in O-bg versus non-O-bg patients after the adjustment for standard predictors. Confirmatory studies are needed to confirm the association between ABO-bg and unfavorable PCa features.

Asociación entre la invasión perineural en la biopsia de próstata dirigida por RMmp y/o sistemática y los resultados patológicos adversos en la prostatectomía radical asistida por robot

Introduction and objectivesThis study aims to investigate the relationship between perineural invasion (PNI) in targeted (TBx) and/or systematic (SBx) prostate needle biopsy and adverse pathological features of prostate cancer (PCa) in prostatectomy specimens. Materials and methodsA total of 95 male patients who underwent transperineal TBx and/or concomitant SBx subsequently treated with robot-assisted radical prostatectomy for PCa between October 2015 and June 2020 were included. The performance of PNI as a classification test (sensitivity, specificity, positive and negative predictive values) and its correlation with clinically significant PCa, surgical margin positivity, extraprostatic extension, and seminal vesicle invasion in prostatectomy were computed. ResultsThe median age of the patients was 65 (60-70) years. TBx and concomitant SBx were performed in 78 (82.1%) patients, while 16 (16.8%) patients underwent SBx alone and one (1.1%) patient underwent TBx alone. The frequency of PNI in TBx and SBx was 17 (21.5%) and 32 (34.0%), respectively. The specificity/negative predictive values of PNI for surgical margin positivity, extraprostatic extension, and seminal vesicle invasion were 79.7/88.7%, 92.5/79.0%, and 83.3/96.8%, in TBx, and 71.1/87.1%, 80.7/74.2%, and 69.5/91.9%, in SBx, respectively. There was also a statistically significant correlation between PNI in biopsy and surgical margin positivity, extraprostatic extension, and seminal vesicle invasion in prostatectomy as well as the ISUP grade group and pT stage. ConclusionsThe absence of PNI in prostate needle biopsy may predict localized PCa with a pT stage≤2c and negative surgical margins in contrast to its presence which appears to be an indicator of unfavorable factors in final pathology.

PO-1772 Radiomic feature relevance in the prediction of pathological features of prostate cancer

PO-1772 Radiomic feature relevance in the prediction of pathological features of prostate cancer

The association between perineural invasion in mpMRI-targeted and/or systematic prostate biopsy and adverse pathological outcomes in robot-assisted radical prostatectomy

Introduction and objectivesThis study aims to investigate the relationship between perineural invasion (PNI) in targeted (TBx) and/or systematic (SBx) prostate needle biopsy and adverse pathological features of prostate cancer (PCa) in prostatectomy specimens. Materials and methodsA total of 95 male patients who underwent transperineal TBx and/or concomitant SBx subsequently treated with robot-assisted radical prostatectomy for PCa between October 2015 and June 2020 were included. The performance of PNI as a classification test (sensitivity, specificity, positive and negative predictive values) and its correlation with clinically significant PCa, surgical margin positivity, extraprostatic extension, and seminal vesicle invasion in prostatectomy were computed. ResultsThe median age of the patients was 65 (60-70) years. TBx and concomitant SBx were performed in 78 (82.1%) patients, while 16 (16.8%) patients underwent SBx alone and one (1.1%) patient underwent TBx alone. The frequency of PNI in TBx and SBx was 17 (21.5%) and 32 (34.0%), respectively. The specificity/negative predictive values of PNI for surgical margin positivity, extraprostatic extension, and seminal vesicle invasion were 79.7/88.7%, 92.5/79.0%, and 83.3/96.8%, in TBx, and 71.1/87.1%, 80.7/74.2%, and 69.5/91.9%, in SBx, respectively. There was also a statistically significant correlation between PNI in biopsy and surgical margin positivity, extraprostatic extension, and seminal vesicle invasion in prostatectomy as well as the ISUP grade group and pT stage. ConclusionsThe absence of PNI in prostate needle biopsy may predict localized PCa with a pT stage ≤ 2c and negative surgical margins in contrast to its presence which appears to be an indicator of unfavorable factors in final pathology.

Evaluation of Clinical and Pathological Characteristics and Routine Treatment of Patients with Prostate Cancer in Six Referral Centers in Iran: A Pilot Non-interventional, Multicenter Study

Background: Prostate cancer is the second most common malignancy among Iranian men after stomach cancer. To understand the nature of the disease and plan and develop a population-based cancer registry, it is essential to recognize the clinical and pathological characteristics of the tumors, as well as treatment results. Objectives: The present study aimed to evaluate the clinical and pathological characteristics of prostate cancer and evaluate the routine practice, including treatment outline and results of treatment in six referral centers in Iran. Methods: This prospective observational pilot study recruited patients with prostate cancer between April 2015 and October 2015 at six referral centers in Iran. The participating physicians included consecutive patients according to inclusion criteria. Demographic, clinicopathologic, and treatment data were collected by the physicians using an electronic case report form (eCRF). The patients were followed for 18 months, and during this period, four visits were scheduled for each patient to collect the data. Results: A total number of 102 patients from six centers in five different cities of Iran were included in the study. Sixty-seven (65.7%) patients were diagnosed by needle biopsy as the first diagnostic method, 23 (22.5%) by radical prostatectomy, and 12 (11.8%) by open prostatectomy. Total at-risk times of patients for overall survival (OS) and progression-free survival (PFS) were 1480.9 and 1437 months, respectively. Median (IQR) values of OS and PFS were 18.2 (9.2 - 20.5) and 18.2 (6.8 - 20.4) months, respectively. Forty (39.2%) patients underwent surgery, 58 (56.8%) underwent radiotherapy, and 13 (12.7%) received chemotherapy. Twenty-nine (28.4%) patients experienced adverse events over the follow-up period. Eight deaths were reported that were unrelated to treatment adverse effects. Conclusions: This pilot registry could serve as a valuable tool for the development of a comprehensive nationwide registry for patients with prostate cancer in Iran.

Pathological features of prostate cancer in men treated with robot-assisted radical prostatectomy in the Middle East

Little is known about the pathological features of radical prostatectomy among men living in the Middle East. Although prostate cancer became the most common malignancy among males in some countries in the Middle East, the incidence is much lower compared to western populations. The aim of this study is to analyze pathological features and biochemical recurrence in men who underwentrobotic-assisted radicalprostatectomy(RARP) in Kuwait. The data on all RARP cases performed by a uro-oncologist (SA) were recorded. A comprehensive database was collected, including demographic, clinical, and pathological data. Between February 2014 and November 2019, 65 RARP cases were performed out of a total of 200 robotic urological procedures. The median follow-up was 41.5months [inter quartile range (IQR) 27.6-52.7]. Eleven (17%) complications occurred in 7 patients, 64% were early (< 30days post-operatively) and minor (Clavien I-II). Thirty-five (54%) patients had ≥ pT3 disease. Overall, 12 (18%) patients had a positive surgical margin (PSM), and all had ≥ pT3 disease. Potency and continence rates at 12months were 82% and 97%, respectively. The mean and SD of the hospital stay were 2.7 ± 1.1days. Biochemical recurrence (BCR) rate was 10%. Men with prostatic adenocarcinoma treated with RARP in Kuwait show a high incidence of pT3 disease. PSM and BCR rates were similar to multiple reports in the literature. To our knowledge, this is the first report of RARP pathological outcomes in the gulf cooperation council (GCC) region of the Middle East.

Contemporary Distribution of High-Grade Prostate Cancer in the Circumstances of Opportunistic Testing

Abstract Screening has dramatically changed the distribution of the mean age, stage and grade of prostate cancer (PCa) at diagnosis. However, regional-level data that characterize contemporary PCa patients are limited. The aim of the study was to ascertain main clinical and pathological characteristics of PCa at the present time in the circumstances of opportunistic testing. High-grade PCa according to age, serum prostate specific antigen (PSA), volume prostate, PSA density (PSAD), digital rectal examination (DRE) number of positive cores biopsies and the average percentage of cancer in biopsy at diagnosis has been retrospectively evaluated in 100 men with biopsyproven PCa, at Clinical Centre Kragujevac, from September 2016 until September 2017. PCa were stratified according to Gleason score (GS) into low/intermediate-grade (GS ≤ 7) and high-grade (GS ≥ 8). To identify the determinants associated with high-grade PCa, we performed univariate and multivariate logistic regression. The most prevalent PCa were the low/intermediate-grade (65%), followed by high-grade (35%). The mean age of the patients was 71.5 (range: 56–88) years and median PSA was 14.6 (range: 1.4–935) ng/ml. There were significant differences in age, PSA, PSAD, DRE, number of positive biopsy and average percentage of cancer in biopsy between patients with or without high-grade GS. Logistic analysis demonstrated the PSAD and age have strong prognostic value of high-grade PCa. In conclusion, our study has shown the worrying frequency of high-grade PCa in the circumstances of opportunistic testing. Older men and higher level of PSAD had a much higher probability of high-grade PCa.

Pathological Characteristics of Prostate Cancer Occurring in Younger Men: A Retrospective Study of Prostatectomy Patients

ObjectiveTo determine if differences exist in the pathological characteristics of prostate cancer occurring in younger men as compared to the disease when it occurs in older men. MethodsA retrospective cohort study was conducted on prostatectomy specimens from the prostate cancer database of a single large Australian pathology practice which services a large proportion of hospitals within 1 state. Data were extracted regarding the pathological characteristics of the cancers and a univariate analysis was conducted against 2 age cutoffs. ResultsData were extracted for all prostatectomy specimens between 2011 and 2017 in 11,551 men. One hundred and thirty-two men were 45 years old and younger, and 545 were 50 years old and younger. Statistically significant differences were found in a number of pathological characteristics. Younger men had lower grade group disease, and within that had less adverse pathological characteristics. In particular, even after controlling for confounding in men 45 and younger, in Grade Group 2 disease there was a lower risk of extra prostatic extension (17.5% vs 34.4%, P = .003), and lymph node involvement (0% vs 0.8%, P = .006), with trends toward superiority in other domains. ConclusionOur results demonstrate that prostate cancer in younger men tends to be lower grade and stage disease compared to older men. This is in contrast to persistent views within the urological community and may have an impact on disease management in younger men.

Pathological Characteristics of Prostate Cancer in Men Aged < 50 Years Treated with Radical Prostatectomy: a Multi-Centre Study in Korea.

BackgroundRecently, younger prostate cancer (PCa) patients have been reported to harbour more favourable disease characteristics after radical prostatectomy (RP) than older men. We analysed young men (<50 years) with PCa among the Korean population, paying attention to pathological characteristics on RP specimen and biochemical recurrence (BCR).MethodsThe multi-centre, Severance Urological Oncology Group registry was utilized to identify 622 patients with clinically localized or locally advanced PCa, who were treated with RP between 2001 and 2017. Patients were dichotomized into two groups according to age (< 50-year-old [n = 75] and ≥ 50-year-old [n = 547]), and clinicopathological characteristics were analysed. Propensity score matching was used when assessing BCR between the two groups.ResultsAlthough biopsy Gleason score (GS) was lower in younger patients (P = 0.033), distribution of pathologic GS was similar between the two groups (13.3% vs. 13.9% for GS ≥ 8, P = 0.191). There was no significant difference in pathologic T stage between the < 50- and ≥ 50-year-old groups (69.3% vs. 68.0% in T2 and 30.7% vs. 32.0% in ≥ T3, P = 0.203). The positive surgical margin rates were similar between the two groups (20.0% vs. 27.6%, P = 0.178). BCR-free survival rates were also similar (P = 0.644) between the two groups, after propensity matching.ConclusionContrary to prior reports, younger PCa patients did not have more favourable pathologic features on RP specimen and showed similar BCR rates compared to older men. These findings should be considered when making treatment decisions for young Korean patients with PCa.

Investigating racial differences in clinical and pathological features of prostate cancer in South African men

Men with West African ancestry living in Europe and North America are at higher risk of being diagnosed with prostate cancer, are diagnosed at a younger age, and have more severe disease characteristics. Published reports present a conflicting picture of the disease in sub-Saharan Africa. We aimed to study the clinical and pathological features of men undergoing prostate biopsy from different racial backgrounds in South Africa in an attempt to characterise the disease locally. Our hypothesis was that black African men presenting to our service had more severe disease characteristics than other patients. All patients who underwent a prostate biopsy at Groote Schuur Hospital, Cape Town from July 2008 to July 2014 were studied. For each patient, data were collected on age, self-assigned race, presenting symptoms, prostate-specific antigen (PSA) level, prostate volume, and histological diagnosis. A total of 1016 patients were studied. 162 (15.9%) were black and 854 (84.1%) were coloured (mixed ancestry), white, or Asian. Black patients were compared as a group to the coloured, white and Asian patients. The black patients in the series had higher PSA values (mean 167.8 vs 47.7, median 16.4 vs 10.9, p < 0.001), were more likely to be diagnosed with cancer (57.4% vs 44.5%, p = 0.003), were more likely to present with locally advanced cancer (T3/4 16.1% vs 8.9%, p = 0.028), and were more likely to have high grade disease (Gleason ≥ 8 45.2% vs 30.5%, p = 0.011). There was no difference in age, presenting symptoms, or prostate volume. The black men diagnosed with prostate cancer at Groote Schuur Hospital had significantly worse clinical and pathological characteristics than the non-black men. Interpreting these differences as representative of a more common or aggressive disease among black men is not possible due to study limitations.

Low levels of serum testosterone in middle-aged men impact pathological features of prostate cancer.

BackgroundSerum testosterone deficiency increases with aging. Age is also a major risk factor for prostate cancer (PrCa) and PCa tumors are more frequently diagnosed among men >65 years old. We evaluated the relationship between preoperative serum testosterone and clinical/ pathological features of PrCa in middle-aged and elderly patients.MethodsA total of 605 PrCa patients who underwent robotic-assisted radical prostatectomy between September 2010 and January 2013 at the University of Pennsylvania, and who had serum testosterone levels measured using Elecsys Testosterone II Immunoassay were included in this IRB-approved protocol. Androgen deficiency was determined as serum free testosterone (FT) <47 pg/ml and total testosterone (TT) <193 ng/dl. Demographic, clinical and tumor characteristics of men with low vs. normal TT or FT were compared using t-test or chi-square tests. Logistic regression was used to determine associations of clinical and pathological variables with FT or TT levels.ResultsAmong middle-aged men (45–64 years; n = 367), those with low FT and low TT had, on average, a higher BMI (29.7 vs. 27.4, P < 0.01; and 32.2 vs. 27.6; P < 0.01, respectively) and higher proportion of Gleason 8–10 PrCa (13.3% vs. 4.8%, P = 0.011; and 19.2% vs. 5.1%, P = 0.012) compared to men with normal FT and normal TT values. Patients with low FT had also higher number of positive cores on biopsy (3.9 vs. 3.1 P = 0.019) and greater tumor volume (7.9 ml vs. 6.1 ml, P = 0.045) compared to those with normal FT. Among men ≥65 years (n = 135) there was no difference in prostatectomy specimens of PrCa between patients with low or normal FT or TT.ConclusionAmong men aged 45–64 years low serum pretreatment FT and TT predicted more aggressive features of PrCa in prostatectomy specimens. In middle-aged patients low testosterone levels measured pre-operatively may indicate more aggressive disease parameters.

Are the Pathological Characteristics of Prostate Cancer More Aggressive or More Indolent Depending upon the Patient Age?

Purpose. To identify pathological characteristics of prostate cancer according to patient age at diagnosis. Methods. A retrospective review of 2,929 men diagnosed with prostate cancer was performed. Pathological characteristics were compared across age groups: ≤55, 56–75, and >75 years. Results. The study cohort included 133 patients (4.5%), 2,033 patients (69.5%), and 763 patients (26.0%) in the three age groups, respectively. The median pathological Gleason sums in the three age groups were 8, 7, and 8, respectively. The Gleason sum, primary Gleason score, and second primary Gleason score were significantly different among the three age groups (Z = 12.975, p = 0.002; Z = 9.264, p = 0.010; Z = 6.692, p = 0.035, resp.). The percentages of Gleason pattern 5 tumors for the three age groups were 44.4%, 32.3%, and 36.8%, respectively; they were significantly different (χ2 = 11.641, p = 0.003). The percentages of tumors with Gleason score grade groups 3–5 for the three age groups were 66.9%, 60.5%, and 66.3%, respectively; they were significantly different (χ2 = 9.401, p = 0.009). Conclusions. The present study indicated that men aged ≤55 years or >75 years show higher levels of clinically significant prostate cancer compared to patients between the ages of 55 and 75 years. Younger and more elderly male patients are more likely to have a more aggressive disease.

Mitochondrial Genome Mutations and Pathological Features of Prostate Cancer: an Update

Mitochondrial Genome Mutations and Pathological Features of Prostate Cancer: an Update

Incidence of intraductal carcinoma, multifocality and bilateral significant disease in radical prostatectomy specimens from Japan and United States.

Significant differences, including epidemiologic, clinical, pathologic and genetic, exist between Asian and Caucasian prostate cancer. Detailed pathologic data are, however, scarce. We studied in detail and compared the pathological features of prostate cancer in radical prostatectomy specimens in 228 patients (117 Japan, 111 US). Japanese prostate cancer had a higher Gleason grade group (mean 2.67 vs. 2.42 US, P < 0.05), but lower pathological stage (72 % pT2 and 28 % pT3 vs 55 % pT2 and 45 % pT3 US, P < 0.05). Japanese cancer showed significantly more tumor foci (3.8 vs 2.9 US, P < 0.05), and higher incidence of bilateral significant disease (81.3 % vs. 66.7 % US, P < 0.05). The dominant tumor nodules in Japanese cases had higher Gleason grade group (mean 2.73 vs. 2.40 US, P < 0.05). The incidence of intraductal carcinoma was significantly higher in Japanese patients (35.3 % vs. 12.6 % US, P < 0.01), which was independent of Gleason score (7: 30.9 % Japan vs 11.8 % US, P < 0.01; ≥ 8: 87.5 % Japan vs 28.6 % US, P < 0.01) and tumor stage (pT2: 24.1 % Japan vs 6.6 % US, P < 0.01; pT3: 62.9 % Japan vs 20 % US, P < 0.01). These findings demonstrate distinct pathological features in prostate cancer between Japanese and Caucasian patients, and may have important diagnostic and therapeutic implications.

Prostate-Specific Antigen Density and Gleason Score Predict Adverse Pathologic Features in Patients with Clinically Localized Prostate Cancer.

BackgroundAccording to recent studies, prostate cancer is the second most common cancer among Iranian men. Radical prostatectomy has been considered the gold standard treatment in patients with clinically localized prostate cancer. Gleason score, PSA density, and PSA velocity are some of the parameters used to predict adverse pathologic features.ObjectivesThe aim of this study was to evaluate the prognostic value of PSA density and Gleason score in predicting adverse pathologic features in patients with localized prostate cancer who undergo radical prostatectomy.MethodsWe conducted a cross-sectional study of 105 patients with localized prostate cancer who underwent radical prostatectomy between 2006 and 2013. We recorded Gleason scores and PSA levels, in addition to the results of pathological evaluations after radical prostatectomy, including prostate volume, stage, LNI (lymph node involvement), SVI (seminal vesicle invasion), and extraprostatic extension (EPE). Data were analyzed using SPSS version 21.ResultsMean PSA density was 0.27 (0.17 SD). The frequencies of EPE, SVI, and LNI were 21.9, 16.2, and 2.9, respectively. The Mann-Whitney U-test demonstrated a significant correlation between PSA density and adverse pathologic features (EPE, SVI, and LNI).ConclusionsPSA, PSA density, and Gleason score should be considered together in order to more accurately predict the adverse pathologic features of prostate cancer.

AB125. The correlation of SRSF1 and survivin in prostate cancer

ObjectiveTo test the expression of serine/arginine rich splicing factor 1 (SRSF1) and survivin [poptosis inhibiting factor (survivin)] in prostate cancer organizations, and study their correlation with the pathological features of prostate cancer, thus put forward the new targets in the treatment of prostate cancer.MethodsSRSF1, survivin protein was analyzed in 20 prostate tissue samples including prostate cancer and benign prostatic hyperplasia by immunohistochemical SP method. SRSF1, survivin was correlated to pathological features, and both the relevance was analyzed (no related reports at home and abroad).ResultsThe positive expression rate of SRSF1 protein in prostate cancer tissue cells was 76.37%±5.06%, significantly higher than that of benign prostatic hyperplasia 11.30%+1.09% (P<0.05); the positive expression rate of survivin protein in prostate cancer tissue cells was 86.93%±3.21%, significantly higher than that of benign prostatic hyperplasia 17.67%±1.99% (P<0.05); SRSF1 and survivin protein expressed in prostate cancer organizations and were positively correlated to pathological Gleason grading, and the second Have significant correlation (P<0.05).ConclusionsSRSF1 and survivin protein were highly expressed in adenocarcinoma tissue, significantly increased than that of benign hyperplasia of prostate tissue. The positive expression SRSF1 and survivin protein were positively correlated to pathological Gleason grading. The expression of survivin protein was elevated with the expression of survivin SRSF1protein in prostate cancer. Preliminary evidence about the role of SRSF1 may be through up-regulation the expression of survivin, thus promote the occurrence and development of prostate cancer.

PD43-07 UPSTAGING ON FINAL PATHOLOGY IN PATIENTS ELIGIBLE FOR ACTIVE SURVEILLANCE WITH SUBDIVISION BY AGE

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VI1 Apr 2016PD43-07 UPSTAGING ON FINAL PATHOLOGY IN PATIENTS ELIGIBLE FOR ACTIVE SURVEILLANCE WITH SUBDIVISION BY AGE Mona Yezdani, Sylvia Yu, Ben Katz, Daniel Maass, Benjamin Taylor, Alexandra Lee, Alice McGill, Kelly Monahan, and David Lee Mona YezdaniMona Yezdani More articles by this author , Sylvia YuSylvia Yu More articles by this author , Ben KatzBen Katz More articles by this author , Daniel MaassDaniel Maass More articles by this author , Benjamin TaylorBenjamin Taylor More articles by this author , Alexandra LeeAlexandra Lee More articles by this author , Alice McGillAlice McGill More articles by this author , Kelly MonahanKelly Monahan More articles by this author , and David LeeDavid Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1785AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active surveillance (AS) has become increasingly utilized and has gained acceptance for the management of men with localized prostate cancer who have low risk clinical features. Our goal was to analyze the preoperative data in men with adenocarcinoma of the prostate and compare this with post prostatectomy specimens in patients who were eligible for AS but chose to undergo robotic-assisted radical prostatectomy (RARP). We also subdivided our data into age categories to assess for a difference. METHODS We performed a single-institution; single-surgeon review of 3433 patients who underwent RARP from 2005 to 2014 under an IRB approved protocol. The inclusion criteria were: PSA ≤ 10, clinical stage T1-T2a, Gleason score 6 or less on biopsy, less than 33% of cores positive and less than 50% of tumor percentage in one core. We compared preoperative data with the pathological features of prostate cancer using t-test (continuous) and chi-square test (categorical). We also subdivided our cohort based on age<50, 50-59, 60-69, >70 and analyzed for a difference in upstaging based on age. RESULTS 3,029 patients had all data points available and of these patients, 1145 qualified for AS. Among them, 571 (50%) were found to have upgraded Gleason scores on their prostatectomy specimen. There were 547 patients upgraded to Gleason 7 (497 to 3+4 and 50 to 4+3), 19 to Gleason 8, and 2 to Gleason 9. Only 1 patient downgraded from Gleason 6 to 5. Positive margins were found in 116 patients (10.1%). Pathologic stage T3 was identified in 103 patients (9%). Also, one patient presented with lymph node involvement on surgical pathology report. 45% of men age <50, 45% of men age 50-59, 54% of men age 60-69, and 63% of men >70 were upstaged after prostatectomy. On chi-squared analysis, this difference across age groups was statistically significant (p=0.0053) CONCLUSIONS Our large cohort study highlights a disturbing percentage of men whose Gleason score was upgraded and staged following RARP. Interestingly, men who were older had a higher risk of upstaging than those that were younger. AS is an encouraging treatment option in the management of prostate cancer; however, appropriate education and counsel should be given to patients about the risks associated with this management style. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e994-e995 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Mona Yezdani More articles by this author Sylvia Yu More articles by this author Ben Katz More articles by this author Daniel Maass More articles by this author Benjamin Taylor More articles by this author Alexandra Lee More articles by this author Alice McGill More articles by this author Kelly Monahan More articles by this author David Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Pretreatment Neutrophil-to-Lymphocyte Ratio

The pretreatment neutrophil-to-lymphocyte ratio (NLR) is reportedly associated with the clinical outcomes of many cancers. However, it has not been widely investigated whether the pretreatment NLR is associated with the pathological characteristics of prostate cancer (PCa) and biochemical recurrence in PCa patients receiving radical prostatectomy (RP).In this cohort study, a total of 1688 PCa patients who had undergone RP were analyzed retrospectively, and a subset of 237 of these patients were evaluated to determine the relationship between pretreatment NLR and biochemical recurrence. Patients were divided into a high-NLR group (NLR ≥2.36) and a low-NLR group (NLR < 2.36) according to the pretreatment NLR. The association between the pretreatment NLR and pathological stage and lymph node involvement was evaluated using logistic regression analysis. Time of biochemical recurrence was determined using the Kaplan–Meier method. Cox's proportional hazard regression model was used to compare the time of biochemical recurrence between the groups.As compared with patients in the low-NLR group, those in the high-NLR group had an increased risk of pT3–4 disease (odds ratio (OR), 1.883; 95% confidence interval (CI), 1.419–2.500; P < 0.001), and a 1.7-fold increased risk of lymph node involvement (OR, 1.685; 95% CI, 1.101–2.579; P = 0.016). For the subset of 237 patients, those with a high NLR showed a significantly shorter median biochemical recurrence-free survival time (51.9 months) than those with a low NLR (76.5 months; log-rank test, P = 0.019). However, multivariate analysis indicated that the NLR was not an independent predictor of biochemical recurrence (hazard ratio, 1.388; 95% CI, 0.909–2.118; P = 0.129).Our findings suggest that the pretreatment NLR may be associated with pathological stage and lymph node involvement in PCa patients receiving RP, and that PCa patients with a high NLR may have a higher rate of biochemical recurrence following RP than those with a low NLR.

Preoperative erectile function and the pathologic features of prostate cancer

Purpose We evaluated whether preoperative erectile function is associated with pathologic features in the patients who underwent radical prostatectomy (RP).Materials and Methods We reviewed medical records of 1,743 men who underwent RP from November 2003 through May 2012. Of these, 50 patients who had prior hormone therapy and 272 patients who had lacking data of International Index of Erectile Function-5 (IIEF-5) were excluded. Men whose IIEF-5 was in the lower 25 percentile were assigned as Low Erectile Function group and the others were assigned as Control group. We compared pathologic features using univariable and multivariable logistic regression analysis between two groups.Results A total of 1,421 patients were included in the analysis. Patients’ age was 65.8 ± 6.7 years and prostate-specific antigen (PSA) was 12.8±16.1 ng/mL. Median and low 25 percentile of IIEF-5 were 14 and 8, respectively. Low Erectile Function group (IIEF-5<8) had higher risk to have high Gleason score (≥7(4+3), odds ratio (OR) 1.642, p<0.001) and large tumor volume (≥5 mL, OR 1.292, p=0.042). Even after adjusting age, year of surgery, body mass index, Charlson comorbidity index, PSA, clinical stage and biopsy Gleason score, Low Erectile Function group still had higher risk of high Gleason score (OR 1.910, p<0.001) and large tumor volume (OR 1.390, p=0.04) by multivariable logistic regressions.Conclusions Lower erectile function before RP was associated with higher Gleason’s score and larger tumor volume in final pathology. Thus, erectile function could be a surrogate barometer for prostate cancer aggressiveness.

MP42-18 PATIENTS ELIGIBLE FOR ACTIVE SURVEILLANCE WHO CHOSE TO UNDERGO PROSTATECTOMY: THE DIFFERENCE BETWEEN PROSTATE CANCER FEATURES ON BIOPSY AND FINAL PATHOLOGIC REPORT

You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2015MP42-18 PATIENTS ELIGIBLE FOR ACTIVE SURVEILLANCE WHO CHOSE TO UNDERGO PROSTATECTOMY: THE DIFFERENCE BETWEEN PROSTATE CANCER FEATURES ON BIOPSY AND FINAL PATHOLOGIC REPORT Benjamin Katz, Sue-Jean Yu, Elton Llukani, Andrew Lightfoot, Kelly Monahan, Alice McGill, and David Lee Benjamin KatzBenjamin Katz More articles by this author , Sue-Jean YuSue-Jean Yu More articles by this author , Elton LlukaniElton Llukani More articles by this author , Andrew LightfootAndrew Lightfoot More articles by this author , Kelly MonahanKelly Monahan More articles by this author , Alice McGillAlice McGill More articles by this author , and David LeeDavid Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1603AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active surveillance (AS) has become an increasing acceptable management option for men with localized prostate cancer who have low risk clinical features. Our goal was to evaluate the preoperative data in men with prostate cancer and correlate this with post prostatectomy specimens in patients who were eligible for AS but chose to undergo robotic-assisted radical prostatectomy (RARP). METHODS We performed a single-institution; single-surgeon review of 3433 patients who underwent RARP from 2005 to 2014 under an IRB approved protocol. The inclusion criteria were: PSA ≤ 10, clinical stage T1-T2a, Gleason score 6 or less on biopsy, less than 33% of cores positive and less than 50% of tumor percentage in one core. We compared preoperative data with the pathological features of prostate cancer using t-test (continuous) and chi-square test (categorical). RESULTS 2,952 patients had all data points available and of these patients, 1131 qualified for AS. Among them, 577 (51%) were found to have upgraded Gleason scores on their prostatectomy specimen. There were 552 patients upgraded to Gleason 7, 21 to Gleason 8, and 3 to Gleason 9. Only 1 patient downgraded from Gleason 6 to 5. Positive margins were found in 118 patients (10.4%), 34 of those being focally positive (3%). Pathologic stage T3 was identified in 106 patients (9.4%). Also, one patient presented with lymph node involvement on surgical pathology report. CONCLUSIONS Our study highlights an alarming percentage of men whose Gleason score was upgraded and staged following RARP. AS is an exciting and promising treatment option in the management of prostate cancer; however, appropriate education and counsel should be given to patients about the risks associated with this management style. Figure 1. Gleason score comparison from pre-operative biopsy to pathology report © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e516 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Katz More articles by this author Sue-Jean Yu More articles by this author Elton Llukani More articles by this author Andrew Lightfoot More articles by this author Kelly Monahan More articles by this author Alice McGill More articles by this author David Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...