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Presence of biopsy Gleason pattern 5 + 3 is associated with higher mortality after radical prostatectomy but not after external beam radiotherapy compared to other Gleason Grade Group IV patterns.
- Source :
-
The Prostate [Prostate] 2021 Aug; Vol. 81 (11), pp. 778-784. Date of Electronic Publication: 2021 May 31. - Publication Year :
- 2021
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Abstract
- Background: We hypothesized that Gleason Grade Group (GGG) IV patients treated with radical prostatectomy (RP) or external beam radiotherapy (EBRT) exhibit different cancer-specific mortality (CSM) rates according to underlying Gleason patterns (GP): 4 + 4 versus 3 + 5 versus 5 + 3.<br />Materials and Methods: We identified all GGG IV patients treated with either RP or EBRT within the Surveillance, Epidemiology, and End Results 2004-2016 database. The effect of biopsy GP on CSM (3 + 5 vs. 4 + 4 vs. 5 + 3) was tested in Kaplan-Meier and multivariable competing risks regression models (adjusted for PSA, age at diagnosis, cT-, and cN-stage).<br />Results: Of 26,458 GGG IV patients, 14,203 (53.7%) were treated with EBRT and 12,255 (46.3%) with RP. Of RP patients, 15.3 versus 81.2 versus 3.4% exhibited biopsy GP 3 + 5 versus 4 + 4 versus 5 + 3 and respective 10-year CSM rates were 6.5 versus 6.2 versus 12.6% (p < .001). In multivariable analyses addressing RP patients, GP 5 + 3 was associated with two-fold higher CSM rate than GP 4 + 4 (p < .001), but not GP 3 + 5 (p = .1). Of EBRT patients, 7.6 versus 89.8 versus 2.6% exhibited biopsy GP 3 + 5 versus 4 + 4 versus 5 + 3 and respective 10-year CSM rates were 12.2 versus 13.8 versus 17.8% (p < .001). In multivariable analyses addressing EBRT patients, no CSM differences according to GP were observed (all p ≥ .4).<br />Conclusion: In GGG IV RP candidates, the presence of biopsy GP 5 + 3 purports a significantly higher CSM than in GP 4 + 4 or 3 + 5. In GGG IV EBRT candidates, no significant CSM differences according to GP were recorded.<br /> (© 2021 The Authors. The Prostate published by Wiley Periodicals LLC.)
- Subjects :
- Aged
Biopsy
Humans
Male
Middle Aged
Prostate-Specific Antigen blood
Prostatic Neoplasms therapy
Radiotherapy methods
SEER Program
Treatment Outcome
Neoplasm Grading
Prostatectomy statistics & numerical data
Prostatic Neoplasms mortality
Prostatic Neoplasms pathology
Radiotherapy statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0045
- Volume :
- 81
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- The Prostate
- Publication Type :
- Academic Journal
- Accession number :
- 34057220
- Full Text :
- https://doi.org/10.1002/pros.24175