Gleason 6 Prostate Cancer in One or Two Biopsy Cores Can Harbor More Aggressive Disease.
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Gleason 6 Prostate Cancer in One or Two Biopsy Cores Can Harbor More Aggressive Disease. / Katz, Mark H; Shikanov, Sergey; Sun, Maxine; Abdollah, Firas; Budäus, Lars; Gong, Edward M; Eggener, Scott E; Steinberg, Gary D; Zagaja, Gregory P; Shalhav, Arieh L; Karakiewicz, Pierre I; Zorn, Kevin C.
in: J ENDOUROL, Jahrgang 25, Nr. 4, 4, 2011, S. 699-703.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Gleason 6 Prostate Cancer in One or Two Biopsy Cores Can Harbor More Aggressive Disease.
AU - Katz, Mark H
AU - Shikanov, Sergey
AU - Sun, Maxine
AU - Abdollah, Firas
AU - Budäus, Lars
AU - Gong, Edward M
AU - Eggener, Scott E
AU - Steinberg, Gary D
AU - Zagaja, Gregory P
AU - Shalhav, Arieh L
AU - Karakiewicz, Pierre I
AU - Zorn, Kevin C
PY - 2011
Y1 - 2011
N2 - Abstract Background and Purpose: Patients with Gleason (GL) 6 prostate cancer in one or two biopsy cores can be upgraded and/or upstaged at the time of surgery, which may adversely impact long-term outcome. A novel model for prediction of adverse pathologic outcomes was developed using preoperative characteristics. Patients and Methods: Between 2003 and 2007, 1159 patients underwent robot-assisted radical prostatectomy (RARP) at our institution. GL 6 prostate cancer in one or two biopsy cores was identified in 416 (36%) patients. Logistic regression analyses were used to assess the rate of GL 7 and/or extraprostatic extension at RARP. Covariates consisted of age, body mass index (BMI), number of positive cores, greatest percent of cancer in a core (GPC), clinical stage, and preoperative prostate-specific antigen (PSA) level. After backward variable selection, the developed model was internally validated using the area under the curve and subjected to methods of calibration. Results: Respectively, 278 (67%) and 138 (33%) patients had one or two positive biopsy cores. At RARP, 90 (22%) patients were upgraded to GL 7 and 37 (9%) had extraprostatic extension. The novel model relied on age, BMI, preoperative PSA level, and GPC for prediction of adverse pathologic outcomes and was 69% accurate. Calibration plot revealed a virtually perfect relationship between predicted and observed probabilities. Conclusions: In patients with GL 6 prostate cancer in one or two biopsy cores, 25% have more ominous pathology at RARP. The model provides an individual assessment of adverse outcomes at surgery. Consequently, it may be considered when counseling patients regarding their management options.
AB - Abstract Background and Purpose: Patients with Gleason (GL) 6 prostate cancer in one or two biopsy cores can be upgraded and/or upstaged at the time of surgery, which may adversely impact long-term outcome. A novel model for prediction of adverse pathologic outcomes was developed using preoperative characteristics. Patients and Methods: Between 2003 and 2007, 1159 patients underwent robot-assisted radical prostatectomy (RARP) at our institution. GL 6 prostate cancer in one or two biopsy cores was identified in 416 (36%) patients. Logistic regression analyses were used to assess the rate of GL 7 and/or extraprostatic extension at RARP. Covariates consisted of age, body mass index (BMI), number of positive cores, greatest percent of cancer in a core (GPC), clinical stage, and preoperative prostate-specific antigen (PSA) level. After backward variable selection, the developed model was internally validated using the area under the curve and subjected to methods of calibration. Results: Respectively, 278 (67%) and 138 (33%) patients had one or two positive biopsy cores. At RARP, 90 (22%) patients were upgraded to GL 7 and 37 (9%) had extraprostatic extension. The novel model relied on age, BMI, preoperative PSA level, and GPC for prediction of adverse pathologic outcomes and was 69% accurate. Calibration plot revealed a virtually perfect relationship between predicted and observed probabilities. Conclusions: In patients with GL 6 prostate cancer in one or two biopsy cores, 25% have more ominous pathology at RARP. The model provides an individual assessment of adverse outcomes at surgery. Consequently, it may be considered when counseling patients regarding their management options.
M3 - SCORING: Zeitschriftenaufsatz
VL - 25
SP - 699
EP - 703
JO - J ENDOUROL
JF - J ENDOUROL
SN - 0892-7790
IS - 4
M1 - 4
ER -