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The Significance of Primary Biopsy Gleason 5 in Patients with Grade Group 5 Prostate Cancer

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The Significance of Primary Biopsy Gleason 5 in Patients with Grade Group 5 Prostate Cancer. / Tilki, Derya; Würnschimmel, Christoph; Preisser, Felix; Graefen, Markus; Huland, Hartwig; Mandel, Philipp; Tennstedt, Pierre.

In: EUR UROL FOCUS, Vol. 6, No. 2, 15.03.2020, p. 255-258.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Tilki, D, Würnschimmel, C, Preisser, F, Graefen, M, Huland, H, Mandel, P & Tennstedt, P 2020, 'The Significance of Primary Biopsy Gleason 5 in Patients with Grade Group 5 Prostate Cancer', EUR UROL FOCUS, vol. 6, no. 2, pp. 255-258. https://doi.org/10.1016/j.euf.2020.01.008

APA

Tilki, D., Würnschimmel, C., Preisser, F., Graefen, M., Huland, H., Mandel, P., & Tennstedt, P. (2020). The Significance of Primary Biopsy Gleason 5 in Patients with Grade Group 5 Prostate Cancer. EUR UROL FOCUS, 6(2), 255-258. https://doi.org/10.1016/j.euf.2020.01.008

Vancouver

Tilki D, Würnschimmel C, Preisser F, Graefen M, Huland H, Mandel P et al. The Significance of Primary Biopsy Gleason 5 in Patients with Grade Group 5 Prostate Cancer. EUR UROL FOCUS. 2020 Mar 15;6(2):255-258. https://doi.org/10.1016/j.euf.2020.01.008

Bibtex

@article{656b1cfb43924a409a42c10590c14c8d,
title = "The Significance of Primary Biopsy Gleason 5 in Patients with Grade Group 5 Prostate Cancer",
abstract = "The five-tier grade group (GG) classification for prostate cancer (PCa) does not differentiate between primary (5+4) or secondary (4+5) histological Gleason 5 pattern in GG 5. We addressed the prognostic value of primary versus secondary biopsy Gleason 5 for GG 5 among 18 555 PCa patients treated with radical prostatectomy (RP) between 1992 and 2014. Of these, 922 patients had GG 5 PCa with primary (n=295) or secondary (n=627) Gleason 5 on biopsy. Prediction of biochemical recurrence (BCR), metastasis, and cancer-specific mortality (CSM) was assessed using Kaplan-Meier curves and univariable/multivariable Cox regression controlling for known prognosticators. Median follow-up was 74.8 mo (interquartile range [IQR] 49.2-120.2). BCR developed in 24.3% of patients (n=4508) at a median of 23.6 mo (IQR 7.1-48.6). Metastasis developed in 4.5% (n=827) and 2.0% (n=370) died of PCa. When stratifying GG 5 by primary versus secondary Gleason 5, the estimated 5-yr metastasis-free survival was 80.4% (95% confidence interval [CI] 76.1-85.0%) versus 86.9% (95% CI 84.2-89.7%; p= 0.002) and cancer-specific survival was 90.9% (95% CI 87.5-94.4%) versus 96.3% (95% CI 94.7-98.0%; p< 0.001). On multivariable analysis, the negative impact of primary biopsy Gleason 5 among GG 5 patients remained significant for metastasis (hazard ratio [HR] 1.58; p< 0.001) and CSM (HR 2.44; p< 0.001). Therefore, stratifying GG 5 into primary (5 + 4, 5 + 5) and secondary (4 + 5) Gleason 5 may be warranted. PATIENT SUMMARY: We recorded worse oncological outcomes for patients with a primary histological Gleason 5 pattern on prostate biopsy compared to patients with a secondary biopsy Gleason 5 pattern.",
author = "Derya Tilki and Christoph W{\"u}rnschimmel and Felix Preisser and Markus Graefen and Hartwig Huland and Philipp Mandel and Pierre Tennstedt",
note = "Copyright {\textcopyright} 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.",
year = "2020",
month = mar,
day = "15",
doi = "10.1016/j.euf.2020.01.008",
language = "English",
volume = "6",
pages = "255--258",
journal = "EUR UROL FOCUS",
issn = "2405-4569",
publisher = "Elsevier BV",
number = "2",

}

RIS

TY - JOUR

T1 - The Significance of Primary Biopsy Gleason 5 in Patients with Grade Group 5 Prostate Cancer

AU - Tilki, Derya

AU - Würnschimmel, Christoph

AU - Preisser, Felix

AU - Graefen, Markus

AU - Huland, Hartwig

AU - Mandel, Philipp

AU - Tennstedt, Pierre

N1 - Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PY - 2020/3/15

Y1 - 2020/3/15

N2 - The five-tier grade group (GG) classification for prostate cancer (PCa) does not differentiate between primary (5+4) or secondary (4+5) histological Gleason 5 pattern in GG 5. We addressed the prognostic value of primary versus secondary biopsy Gleason 5 for GG 5 among 18 555 PCa patients treated with radical prostatectomy (RP) between 1992 and 2014. Of these, 922 patients had GG 5 PCa with primary (n=295) or secondary (n=627) Gleason 5 on biopsy. Prediction of biochemical recurrence (BCR), metastasis, and cancer-specific mortality (CSM) was assessed using Kaplan-Meier curves and univariable/multivariable Cox regression controlling for known prognosticators. Median follow-up was 74.8 mo (interquartile range [IQR] 49.2-120.2). BCR developed in 24.3% of patients (n=4508) at a median of 23.6 mo (IQR 7.1-48.6). Metastasis developed in 4.5% (n=827) and 2.0% (n=370) died of PCa. When stratifying GG 5 by primary versus secondary Gleason 5, the estimated 5-yr metastasis-free survival was 80.4% (95% confidence interval [CI] 76.1-85.0%) versus 86.9% (95% CI 84.2-89.7%; p= 0.002) and cancer-specific survival was 90.9% (95% CI 87.5-94.4%) versus 96.3% (95% CI 94.7-98.0%; p< 0.001). On multivariable analysis, the negative impact of primary biopsy Gleason 5 among GG 5 patients remained significant for metastasis (hazard ratio [HR] 1.58; p< 0.001) and CSM (HR 2.44; p< 0.001). Therefore, stratifying GG 5 into primary (5 + 4, 5 + 5) and secondary (4 + 5) Gleason 5 may be warranted. PATIENT SUMMARY: We recorded worse oncological outcomes for patients with a primary histological Gleason 5 pattern on prostate biopsy compared to patients with a secondary biopsy Gleason 5 pattern.

AB - The five-tier grade group (GG) classification for prostate cancer (PCa) does not differentiate between primary (5+4) or secondary (4+5) histological Gleason 5 pattern in GG 5. We addressed the prognostic value of primary versus secondary biopsy Gleason 5 for GG 5 among 18 555 PCa patients treated with radical prostatectomy (RP) between 1992 and 2014. Of these, 922 patients had GG 5 PCa with primary (n=295) or secondary (n=627) Gleason 5 on biopsy. Prediction of biochemical recurrence (BCR), metastasis, and cancer-specific mortality (CSM) was assessed using Kaplan-Meier curves and univariable/multivariable Cox regression controlling for known prognosticators. Median follow-up was 74.8 mo (interquartile range [IQR] 49.2-120.2). BCR developed in 24.3% of patients (n=4508) at a median of 23.6 mo (IQR 7.1-48.6). Metastasis developed in 4.5% (n=827) and 2.0% (n=370) died of PCa. When stratifying GG 5 by primary versus secondary Gleason 5, the estimated 5-yr metastasis-free survival was 80.4% (95% confidence interval [CI] 76.1-85.0%) versus 86.9% (95% CI 84.2-89.7%; p= 0.002) and cancer-specific survival was 90.9% (95% CI 87.5-94.4%) versus 96.3% (95% CI 94.7-98.0%; p< 0.001). On multivariable analysis, the negative impact of primary biopsy Gleason 5 among GG 5 patients remained significant for metastasis (hazard ratio [HR] 1.58; p< 0.001) and CSM (HR 2.44; p< 0.001). Therefore, stratifying GG 5 into primary (5 + 4, 5 + 5) and secondary (4 + 5) Gleason 5 may be warranted. PATIENT SUMMARY: We recorded worse oncological outcomes for patients with a primary histological Gleason 5 pattern on prostate biopsy compared to patients with a secondary biopsy Gleason 5 pattern.

U2 - 10.1016/j.euf.2020.01.008

DO - 10.1016/j.euf.2020.01.008

M3 - SCORING: Journal article

C2 - 32033909

VL - 6

SP - 255

EP - 258

JO - EUR UROL FOCUS

JF - EUR UROL FOCUS

SN - 2405-4569

IS - 2

ER -