Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer
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Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer. / Hoeh, Benedikt; Flammia, Rocco; Hohenhorst, Lukas; Sorce, Gabriele; Chierigo, Francesco; Tian, Zhe; Saad, Fred; Gallucci, Michele; Briganti, Alberto; Terrone, Carlo; Shariat, Shahrokh F; Graefen, Markus; Tilki, Derya; Kluth, Luis A; Mandel, Philipp; Chun, Felix K H; Karakiewicz, Pierre I.
In: PROSTATE INT, Vol. 10, No. 1, 03.2022, p. 21-27.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer
AU - Hoeh, Benedikt
AU - Flammia, Rocco
AU - Hohenhorst, Lukas
AU - Sorce, Gabriele
AU - Chierigo, Francesco
AU - Tian, Zhe
AU - Saad, Fred
AU - Gallucci, Michele
AU - Briganti, Alberto
AU - Terrone, Carlo
AU - Shariat, Shahrokh F
AU - Graefen, Markus
AU - Tilki, Derya
AU - Kluth, Luis A
AU - Mandel, Philipp
AU - Chun, Felix K H
AU - Karakiewicz, Pierre I
N1 - © 2022 Asian Pacific Prostate Society. Published by Elsevier B.V.
PY - 2022/3
Y1 - 2022/3
N2 - BACKGROUND: Up- and/or downgrading rates in single intermediate-risk positive biopsy core are unknown.METHODS: We identified single intermediate-risk (Gleason grade group (GGG) 2/GGG3) positive biopsy core prostate cancer patients (≤ cT2c and PSA ≤ 20 ng/mL) within the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015). Subsequently, separate uni- and multivariable logistic regression models tested for independent predictors of up- and downgrading.RESULTS: Of 1,328 assessable patients with single core positive intermediate-risk prostate cancer at biopsy, 972 (73%) harbored GGG2 versus 356 (27%) harbored GGG3. Median PSA (5.5 vs 5.7; p = 0.3), median age (62 vs 63 years; p = 0.07) and cT1-stage (77 vs 75%; p = 0.3) did not differ between GGG2 and GGG3 patients. Of individuals with single GGG2 positive biopsy core, 191 (20%) showed downgrading to GGG1 versus 35 (4%) upgrading to GGG4 or GGG5 at RP. Of individuals with single GGG3 positive biopsy core, 36 (10%) showed downgrading to GGG1 versus 42 (12%) significant upgrading to GGG4 or GGG5 at RP. In multivariable logistic regression models, elevated PSA (10-20 ng/mL) was an independent predictor of upgrading to GGG4/GGG5 in single GGG3 positive biopsy core patients (OR:2.89; 95%-CI: 1.31-6.11; p = 0.007).CONCLUSION: In single GGG2 positive biopsy core patients, downgrading was four times more often recorded compared to upgrading. Conversely, in single GGG3 positive biopsy core patients, up- and downgrading rates were comparable and should be expected in one out of ten patients.
AB - BACKGROUND: Up- and/or downgrading rates in single intermediate-risk positive biopsy core are unknown.METHODS: We identified single intermediate-risk (Gleason grade group (GGG) 2/GGG3) positive biopsy core prostate cancer patients (≤ cT2c and PSA ≤ 20 ng/mL) within the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015). Subsequently, separate uni- and multivariable logistic regression models tested for independent predictors of up- and downgrading.RESULTS: Of 1,328 assessable patients with single core positive intermediate-risk prostate cancer at biopsy, 972 (73%) harbored GGG2 versus 356 (27%) harbored GGG3. Median PSA (5.5 vs 5.7; p = 0.3), median age (62 vs 63 years; p = 0.07) and cT1-stage (77 vs 75%; p = 0.3) did not differ between GGG2 and GGG3 patients. Of individuals with single GGG2 positive biopsy core, 191 (20%) showed downgrading to GGG1 versus 35 (4%) upgrading to GGG4 or GGG5 at RP. Of individuals with single GGG3 positive biopsy core, 36 (10%) showed downgrading to GGG1 versus 42 (12%) significant upgrading to GGG4 or GGG5 at RP. In multivariable logistic regression models, elevated PSA (10-20 ng/mL) was an independent predictor of upgrading to GGG4/GGG5 in single GGG3 positive biopsy core patients (OR:2.89; 95%-CI: 1.31-6.11; p = 0.007).CONCLUSION: In single GGG2 positive biopsy core patients, downgrading was four times more often recorded compared to upgrading. Conversely, in single GGG3 positive biopsy core patients, up- and downgrading rates were comparable and should be expected in one out of ten patients.
U2 - 10.1016/j.prnil.2022.01.004
DO - 10.1016/j.prnil.2022.01.004
M3 - SCORING: Journal article
C2 - 35261911
VL - 10
SP - 21
EP - 27
JO - PROSTATE INT
JF - PROSTATE INT
SN - 2287-8882
IS - 1
ER -