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- Danneman, Daniela, et al.
(författare)
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Accuracy of prostate biopsies for predicting Gleason score in radical prostatectomy specimens : nationwide trends 2000-2012
- 2017
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Ingår i: BJU International. - : Wiley. - 1464-4096 .- 1464-410X. ; 119:1, s. 50-56
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To investigate how well the Gleason score in diagnostic needle biopsies predicted the Gleason score in a subsequent radical prostatectomy (RP) specimen before and after the 2005 International Society of Urological Pathology (ISUP) revision of Gleason grading, and if the recently proposed ISUP grades 1-5 (corresponding to Gleason scores 6, 3 + 4, 4 + 3, 8 and 9-10) better predict the RP grade. Patients and Methods All prostate cancers diagnosed in Sweden are reported to the National Prostate Cancer Register (NPCR). We analysed the Gleason scores and ISUP grades from the diagnostic biopsies and the RP specimens in 15 598 men in the NPCR who: were diagnosed between 2000 and 2012 with clinical stage T1-2 M0/X prostate cancer on needle biopsy; were aged <= 70 years; had serum PSA concentration of < 20 ng/mL; and underwent a RP < 6 months after diagnosis as their primary treatment. Results Prediction of RP Gleason score increased from 55 to 68% between 2000 and 2012. Most of the increase occurred before 2005 (nine percentage points; P < 0.001); however, when adjusting for Gleason score and year of diagnosis in a multivariable analysis, the prediction of RP Gleason score decreased over time (odds ratio [OR] 0.98; P < 0.002). A change in the ISUP grades would have led to a decreasing agreement between biopsy and RP grades over time, from 68% in 2000 to 57% in 2012, with an OR of 0.95 in multivariable analysis (P < 0.001). Conclusion Agreement between biopsy and RP Gleason score improved from 2000 to 2012, with most of the improvement occurring before the 2005 ISUP grading revision. Had ISUP grades been used instead of Gleason score, the agreement between biopsy and RP grade would have decreased, probably because of its separation of Gleason score 7 into ISUP grades 2 and 3 (Gleason score 3 + 4 vs 4 + 3).
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| 2. |
- Egevad, Lars, et al.
(författare)
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Prognostic Significance of Prostate Cancer with Seminal Vesicle Invasion on Radical Prostatectomy : A National Registry Study
- 2017
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Ingår i: Modern Pathology. - Karolinska Inst, Stockholm, Sweden. Univ Uppsala Hosp, Uppsala, Sweden. Univ Otago, Wellington Sch Med & Hlth Sci, Wellington, New Zealand. Aquesta Pathol, Brisbane, Qld, Australia. : NATURE PUBLISHING GROUP. - 0893-3952 .- 1530-0285. ; 97, s. 222A-222A
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Kristiansen, Anna, et al.
(författare)
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Prognostic significance and biopsy characteristics of prostate cancer with seminal vesicle invasion on radical prostatectomy : a nationwide population-based study
- 2017
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Ingår i: Pathology. - : ELSEVIER SCIENCE BV. - 0031-3025 .- 1465-3931. ; 49:7, s. 715-720
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate the prognostic significance of seminal vesicle invasion (SVI, pT3b) compared with extraprostatic extension (EPE) alone (pT3a) after radical prostatectomy, and to correlate pre-operative biopsy pathology with SVI and EPE. The National Prostate Cancer Register includes all prostate cancers diagnosed in Sweden. We analysed 4063 cases with stage category pT3a and 1371 cases with pT3b at radical prostatectomy between 2000 and 2012. Associations between pT3a and pT3b and progression were evaluated and adjusted for year, age, biopsy grade and s-PSA. Needle biopsy findings in these stages were compared. Patients with pT3b (n = 1371) had a higher risk of death from prostate cancer (HR 2.3, 95% CI 1.5-3.3, p < 0.001) and death from any cause (HR 1.5, 95% CI 1.2-1.8, p < 0.001) than those with pT3a (n = 4063). They were also more likely to be treated with post-operative radiotherapy (HR 1.5, 95% CI 1.4-1.7, p < 0.001) or androgen deprivation therapy (HR 3.0, 95% CI 2.5-3.7, p < 0.001), indicating clinical progression. Yet, disease-specific survival of patients with stage pT3b was 94% after 6 years. Median cancer extent in pre-operative biopsies of pT3a and pT3b was 14 and 24 mm (p < 0.001), number of positive cores was four and five, (p < 0.001) and biopsy Gleason score was 8-10 in 11.6% and 27.3%, respectively (p < 0.001). SVI of prostate cancer is associated with worse outcome after radical prostatectomy than EPE alone. However, few patients with SVI die within 6 years from surgery, suggesting that radical prostatectomy may be curative in locally advanced cancers.
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