Perineural invasion on biopsy is associated with upstaging at radical prostatectomy in Gleason score 3 + 4 = 7 prostate cancer

2016 ◽  
Vol 66 (11) ◽  
pp. 629-632 ◽  
Author(s):  
Trevor A. Flood ◽  
Nicola Schieda ◽  
Daniel T. Keefe ◽  
Chris Morash ◽  
Justin Bateman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Perineural Invasion

scholarly journals Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer?

2015 ◽  
Vol 9 (5-6) ◽  
pp. 252 ◽  
Author(s):  
Fairleigh Reeves ◽  
Christopher M. Hovens ◽  
Laurence Harewood ◽  
Shayne Battye ◽  
Justin S. Peters ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Regression Analysis ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
Perineural Invasion ◽  
Cox Regression ◽  
Clinicopathological Parameters ◽  
Positive Surgical Margin ◽  
Cox Regression Analysis

Introduction: The ability of perineural invasion (PNI) in radical prostatectomy (RP) specimens to predict biochemical recurrence (BCR) is unclear. This study investigates this controversial question in a large cohort.Methods: A retrospective analysis was undertaken of prospectively collected data from 1497 men who underwent RP (no neoadjuvant therapy) for clinically localized prostate cancer. The association of PNI at RP with other clinicopathological parameters was evaluated. The correlation of clinicopathological factors and BCR (defined as prostate-specific antigen [PSA] >0.2 ng/mL) was investigated with univariable and multivariable Cox regression analysis in 1159 men.Results: PNI-positive patients were significantly more likely to have a higher RP Gleason score, pT3 disease, positive surgical margins, and greater cancer volume (p < 0.0005). The presence of PNI significantly correlated with BCR on univariable (hazard ratio 2.30, 95% confidence interval 1.50–3.55, p < 0.0005), but not multivariable analysis (p = 0.602). On multivariable Cox regression analysis the only independent prognostic factors were preoperative PSA, RP Gleason score, pT-stage, and positive surgical margin status. These findings are limited by a relatively short follow-up time and retrospective study design.Conclusions: PNI at RP is not an independent predictor of BCR. Therefore, routine reporting of PNI is not indicated. Future research should be targeted at the biology of PNI to increase the understanding of its role in prostate cancer progression.

Use of the Prostate Health Index for the Detection of Aggressive Prostate Cancer at Radical Prostatectomy

2015 ◽  
Vol 95 (4) ◽  
pp. 390-399 ◽  
Author(s):  
Luigi Mearini ◽  
Elisabetta Nunzi ◽  
Carla Ferri ◽  
Guido Bellezza ◽  
Carolina Lolli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Health Index ◽  
Final Pathology ◽  
High Risk Disease ◽  
Prostate Health Index ◽  
Prostate Health

Introduction: In current study, we compared the accuracy of the PSA isoform p2PSA and its derivatives, the percentage of p2PSA to free PSA (%p2PSA) and the Prostate Health Index (PHI) in the detection of prostate cancer (PC) characteristics at the final pathology with respect to reference standards. Materials and Methods: This was an observational prospective study evaluating 43 consecutive PC patients treated with laparoscopic/robotic radical prostatectomy (RP). Logistic regression models were fitted to test the predictors of pT3 stage, pathologic Gleason score ≥8 or Gleason score upgrading, margin status, lymph node invasion, and the presence of high-risk disease (pT3 disease and/or Gleason score ≥8 and/or positive lymph node). The comparative base model included tPSA, clinical stage, biopsy Gleason score, and percentage of positive core. Results: Seventeen patients (39.5%) were affected by pT3 disease or had a pathologic Gleason score ≥8; positive margins were detected in 12 patients (27.9%), lymph node invasion was found in 2 patients (4.7%), and 15 patients (34.8%) harbored high-risk disease. In the univariate analysis, p2PSA, %p2PSA, and PHI were significant predictors of pT3 disease, pathologic Gleason score, and the presence of high-risk disease (all p < 0.05), whereas only PHI was an independent predictor of pT3 disease, margin status, and presence of high-risk disease, increasing the accuracy of a base multivariable model by 6.3% (p < 0.05) and 4.2% (p < 0.05) for the prediction of pT3 and high-risk disease, respectively. Conclusions: p2PSA and its derivatives, primarily PHI, were significant predictors of unfavorable PC characteristics as detected at the final pathology, thus improving the clinical performance of standard prognostic factors for aggressive disease.

scholarly journals Androgen Receptor Expression of Prostate Cancer Correlates with Gleason Score and Perineural Invasion in West Sumatera, Indonesia

2020 ◽  
Vol 7 (11) ◽  
pp. 5125-5129
Author(s):  
Anandia Putriyuni ◽  
Meta Zulyati Oktora
Keyword(s):  
Prostate Cancer ◽  
Androgen Receptor ◽  
Gleason Score ◽  
Cancer Progression ◽  
Perineural Invasion ◽  
Receptor Expression ◽  
Grade Group ◽  
Who Grade ◽  
Who Grade Group ◽  
Histopathological Grading

Prostate cancer is the second most common and the fifth leading cause of death by cancer in men worldwide now. The failure of androgen deprivation therapy (ADT) for prostate cancer caused by activated androgen receptor (AR) signaling pathways mostly found. The role of AR in growth and progression of prostate cancer is still unclear. Analysis of AR expression in prostate cancer has never been done in West Sumatera. This study aims to determine AR expression of prostate cancer and correlate with Gleason score and perineural invasion. A total of 56 prostate cancer from department of anatomical pathology in West Sumatera. Hematoxylin and eosin (HE) stained slides and paraffin blocks were retrieved. Slides of all cases were evaluated to review Gleason score, histopathological grading, WHO grade group based on ISUP 2014/WHO 2016 and perineural invasion. Androgen receptor immunohistochemistry (IHC) was applied on all cases. High AR expression was the mostly found (51,79%). The mostly prostate cancer is Gleason score 9 (44,64%), histopathological grading poorly differentiated/undifferentiated (76,78%), WHO grade group 5 (48,21%). Perineural invasion was noted in 39,29%. There was significant statistical correlation between AR expression and Gleason score, but no significant correlation with perineural invasion. AR expression is the important marker of prostate cancer progression.

scholarly journals Histological Findings in Very Low Risk Prostate Cancer Patients Managed with Radical Prostatectomy

2017 ◽  
Vol 58 (3) ◽  
Author(s):  
Carlos Gustavo Trujillo Ordoñez ◽  
Anamaria Ramos Hernández ◽  
Daniela Robledo Cárdenas ◽  
Ángela Marcela Mariño Álvarez ◽  
Juan Guillermo Cataño Cataño ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Locally Advanced ◽  
Pelvic Lymphadenectomy ◽  
Low Risk ◽  
Histological Findings ◽  
Risk Prostate Cancer ◽  
Locally Advanced Tumors ◽  
Clinical Records

<p><strong>Abstract</strong></p><p><strong>Objectives: </strong>To describe the histological findings in patients with prostate cancer (PCa) clinically classified as very low risk who underwent treatment with radical prostatectomy (RP). <strong>Material and methods: </strong>A retrospective observational study was conducted. Clinical records of patients who underwent RP between 2007-2015 who met Epstein criteria for very low risk disease were reviewed. Histological diagnosis was described and analyzed to determine if such criteria predicted very low risk. <strong>Results: </strong>A total of 609 records were reviewed; 83 (13.6%) met Epstein’s criteria. Mean age was 59 (SD±7) years and median PSA at diagnosis was 5.4 ng/dl (IQR 4.3 – 6.8). Pathology showed a median tumor volume of 4% (IQR 1 – 10%). Gleason score was 3+3 in 55 (66.3%) cases, but 28 (33.7%) were reclassified to a greater score. Two (2.4%) patients were reclassified as pT3a, 80 (96.4%) as pT2 and 1 (1.2%) was found to be pT0. In those subjected to pelvic lymphadenectomy (42.2%) no positive lymph nodes were found. <strong>Conclusions: </strong>Up to one-third of the patients clinically classified with very low risk PCa had a greater Gleason score. Only 3% had locally advanced tumors, which is comparable to previous studies. Epstein’s criteria seem to be adequate in predicting organ-confined disease. </p>

scholarly journals Clinical and pathological variables that predict changes in tumour grade after radical prostatectomy in patients with prostate cancer

2013 ◽  
Vol 7 (1-2) ◽  
pp. 93 ◽  
Author(s):  
Stavros Sfoungaristos ◽  
Petros Perimenis
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Secondary Analysis ◽  
Intraepithelial Neoplasia ◽  
Treatment Modalities ◽  
Psa Density ◽  
Group 2

Introduction: Preoperative Gleason score is crucial, in combination with other preoperative parameters, in selecting the appropriate treatment for patients with clinically localized prostate cancer. The aim of the present study is to determine the clinical and pathological variables that can predict differences in Gleason score between biopsy and radical prostatectomy.Methods: We retrospectively analyzed the medical records of 302 patients who had a radical prostatectomy between January 2005 and September 2010. The association between grade changes and preoperative Gleason score, age, prostate volume, prostate-specific antigen (PSA), PSA density, number of biopsy cores, presence of prostatitis and high-grade prostatic intraepithelial neoplasia was analyzed. We also conducted a secondary analysis of the factors that influence upgrading in patients with preoperative Gleason score ≤6 (group 1) and downgrading in patients with Gleason score ≤7 (group 2).Results: No difference in Gleason score was noted in 44.3% of patients, while a downgrade was noted in 13.7% and upgrade in 42.1%. About 2/3 of patients with a Gleason score of ≤6 upgraded after radical prostatectomy. PSA density (p = 0.008) and prostate volume (p = 0.032) were significantly correlated with upgrade. No significant predictors were found for patients with Gleason score ≤7 who downgraded postoperatively.Conclusion: Smaller prostate volume and higher values of PSA density are predictors for upgrade in patients with biopsy Gleason score ≤6 and this should be considered when deferred treatment modalities are planned.

scholarly journals Does Gleason score of positive surgical margin after radical prostatectomy affect biochemical recurrence and oncological outcomes? Protocol for systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034612
Author(s):  
Athul John ◽  
Michael O'Callaghan ◽  
Rick Catterwell ◽  
Luke A Selth
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
Surgical Margins ◽  
Secondary Treatment ◽  
Oncological Outcomes

IntroductionPositive surgical margins (PSM) in cancer patients are commonly associated with worse prognosis and a higher risk of secondary treatment. However, the relevance of this parameter in prostate cancer patients undergoing radical prostatectomy (RP) remains controversial, given the inconsistencies in its ability to predict biochemical recurrence (BCR) and oncological outcomes. Hence, further assessment of the utility of surgical margins for prostate cancer prognosis is required to predict these outcomes more accurately. Over the last decade, studies have used the Gleason score (GS) of positive margins to predict outcomes. Herein, the authors aim to conduct a systematic review investigating the role of GS of PSM after radical prostatectomy in predicting BCR and oncological outcomes.Methods and analysisWe will perform a search using MEDLINE, EMBASE, SCOPUS and COCHRANE databases. The review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will screen titles and abstracts to select articles appropriate for full-text review. Studies discussing GS of PSM after RP will be included. Given the change in reporting of GS, only articles from 2005 to 2019 will be included. The quality of the studies chosen will be assessed using the Newcastle Ottawa tool for non-randomised and Cochrane risk of bias for randomised control studies. We will adopt the grading of recommendations, assessment, development and evaluation framework to comment on quality of cumulative evidence. The primary outcome measure will be time to BCR. Secondary outcome measures include secondary treatment, disease-specific survival, disease progression-free and overall mortality at follow-up period. We aim to perform a meta-analysis if the level of heterogeneity is acceptable (I2<50%).Ethics and disseminationThe review does not require ethics approval as it is a review of published literature. The findings of the review will be submitted for peer-reviewed publications and presented at scientific meetings.PROSPERO registration numberCRD42019131800.

scholarly journals Gene expression signature of Gleason score is associated with prostate cancer outcomes in a radical prostatectomy cohort

Oncotarget ◽  
2017 ◽  
Vol 8 (26) ◽  
pp. 43035-43047 ◽  
Author(s):  
Min A. Jhun ◽  
Milan S. Geybels ◽  
Jonathan L. Wright ◽  
Suzanne Kolb ◽  
Craig April ◽  
...  
Keyword(s):  
Gene Expression ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Gene Expression Signature ◽  
Cancer Outcomes ◽  
Expression Signature

scholarly journals Prediction of prostate cancer Gleason score upgrading from biopsy to radical prostatectomy using pre-biopsy multiparametric MRI PIRADS scoring system

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Saeed Alqahtani ◽  
Cheng Wei ◽  
Yilong Zhang ◽  
Magdalena Szewczyk-Bieda ◽  
Jennifer Wilson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Scoring System ◽  
Multiparametric Mri
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