The association of the type and number of D'Amico high-risk criteria with rates of pathologically non-organ-confined prostate cancer
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The association of the type and number of D'Amico high-risk criteria with rates of pathologically non-organ-confined prostate cancer. / Chierigo, Francesco; Flammia, Rocco Simone; Sorce, Gabriele; Hoeh, Benedikt; Hohenhorst, Lukas; Tian, Zhe; Saad, Fred; Gallucci, Michele; Briganti, Alberto; Montorsi, Francesco; Chun, Felix K H; Graefen, Markus; Shariat, Shahrokh F; Guano, Giovanni; Mantica, Guglielmo; Borghesi, Marco; Suardi, Nazareno; Terrone, Carlo; Karakiewicz, Pierre I.
in: CENT EUR J UROL, Jahrgang 76, Nr. 2, 2023, S. 104-108.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - The association of the type and number of D'Amico high-risk criteria with rates of pathologically non-organ-confined prostate cancer
AU - Chierigo, Francesco
AU - Flammia, Rocco Simone
AU - Sorce, Gabriele
AU - Hoeh, Benedikt
AU - Hohenhorst, Lukas
AU - Tian, Zhe
AU - Saad, Fred
AU - Gallucci, Michele
AU - Briganti, Alberto
AU - Montorsi, Francesco
AU - Chun, Felix K H
AU - Graefen, Markus
AU - Shariat, Shahrokh F
AU - Guano, Giovanni
AU - Mantica, Guglielmo
AU - Borghesi, Marco
AU - Suardi, Nazareno
AU - Terrone, Carlo
AU - Karakiewicz, Pierre I
N1 - Copyright by Polish Urological Association.
PY - 2023
Y1 - 2023
N2 - INTRODUCTION: The aim of this study was to assess the association between the type and number of D'Amico high-risk criteria (DHRCs) with rates of pathologically non-organ-confined (NOC) prostate cancer in patients treated with radical prostatectomy (RP) and pelvic lymphadenectomy (PLND).MATERIAL AND METHODS: In the Surveillance, Epidemiology, and End Results database (2004-2016), we identified 12961 RP and PLDN patients with at least one DHRC. We relied on descriptive statistics and multivariable logistic regression models.RESULTS: Of 12 961 patients, 6135 (47%) exclusively harboured biopsy Gleason score (GS) 8-10, 3526 (27%) had clinical stage ≥T2c, and 1234 (9.5%) had prostate-specific antigen (PSA) >20 ng/mL. Only 1886 (15%) harboured any combination of 2 DHRCs. Finally, all 3 DHRCs were present in 180 (1.4%) patients. NOC rates increased from 32% for clinical T stage ≥T2c to 49% for either GS 8-10 only or PSA >20 ng/mL only and to 66-68% for any combination of 2 DHRCs, and to 84% for respectively all 3 DHRCs, which resulted in a multivariable logistic regression OR of 1.00, 2.01 (95% CI 1.85-2.19; p <0.001), 4.16 (95% CI 3.69-4.68; p <0.001), and 10.83 (95% CI 7.35-16.52; p <0.001), respectively.CONCLUSIONS: Our study indicates a stimulus-response effect according to the type and number of DHRCs. Hence, a formal risk-stratification within high-risk prostate cancer patients should be considered in clinical decision-making.
AB - INTRODUCTION: The aim of this study was to assess the association between the type and number of D'Amico high-risk criteria (DHRCs) with rates of pathologically non-organ-confined (NOC) prostate cancer in patients treated with radical prostatectomy (RP) and pelvic lymphadenectomy (PLND).MATERIAL AND METHODS: In the Surveillance, Epidemiology, and End Results database (2004-2016), we identified 12961 RP and PLDN patients with at least one DHRC. We relied on descriptive statistics and multivariable logistic regression models.RESULTS: Of 12 961 patients, 6135 (47%) exclusively harboured biopsy Gleason score (GS) 8-10, 3526 (27%) had clinical stage ≥T2c, and 1234 (9.5%) had prostate-specific antigen (PSA) >20 ng/mL. Only 1886 (15%) harboured any combination of 2 DHRCs. Finally, all 3 DHRCs were present in 180 (1.4%) patients. NOC rates increased from 32% for clinical T stage ≥T2c to 49% for either GS 8-10 only or PSA >20 ng/mL only and to 66-68% for any combination of 2 DHRCs, and to 84% for respectively all 3 DHRCs, which resulted in a multivariable logistic regression OR of 1.00, 2.01 (95% CI 1.85-2.19; p <0.001), 4.16 (95% CI 3.69-4.68; p <0.001), and 10.83 (95% CI 7.35-16.52; p <0.001), respectively.CONCLUSIONS: Our study indicates a stimulus-response effect according to the type and number of DHRCs. Hence, a formal risk-stratification within high-risk prostate cancer patients should be considered in clinical decision-making.
U2 - 10.5173/ceju.2023.030
DO - 10.5173/ceju.2023.030
M3 - SCORING: Journal article
C2 - 37483849
VL - 76
SP - 104
EP - 108
JO - CENT EUR J UROL
JF - CENT EUR J UROL
SN - 2080-4806
IS - 2
ER -