Predicting the Gleason sum of a patient with a prostate biopsy core Gleason ≤7 and a prostate biopsy core Gleason ≥8

Authors

  • Olivier P. Heimrath Urology Resident, McGill University Division of Urology, Department of Surgery Montreal General Hospital 1650 Cedar Ave, Room L8.107 Montreal, QC H3G 1A4
  • Zuzana Kos Pathology Resident, University of Ottawa Division of Anatomical Pathology Department of Pathology and Laboratory Medicine The Ottawa Hospital 501 Smyth Road, CCW, 4th Floor, Rm 4107 Ottawa, ON, K1H 8L6
  • Eric C. Belanger Assistant Professor, University of Ottawa Staff Pathologist, Division of Anatomical Pathology Department of Pathology and Laboratory Medicine The Ottawa Hospital 501 Smyth Road, CCW, 4th Floor, Rm 4107 Ottawa, ON, K1H 8L6
  • Ilias Cagiannos Associate Professor of Surgery, University of Ottawa Surgical Oncologist, Division of Urology, The Ottawa Hospital Urologic Oncology Fellowship Director 501 Smyth Rd, Ottawa, ON, K1H 8L6
  • Chris Morash Associate Professor of Surgery, University of Ottawa Medical Director, The Ottawa Hospital Prostate Cancer Assessment Centre 501 Smyth Rd, Ottawa, ON, K1H 8L6
  • Ronald G. Gerridzen Professor and Chair, Division of Urology Chair, Department of Surgery Finance Committee The University of Ottawa Chief, Division of Urology, The Ottawa Hospital 501 Smyth Rd, Ottawa, ON, K1H 8L6
  • Luke Lavallee Urologic Oncology Fellow, University of Ottawa Division of Urology, Department of Surgery, The Ottawa Hospital 501 Smyth Rd, Ottawa, ON, K1H 8L6
  • Mark A. Preston Urology Fellow Department of Urology, Massachusetts General Hospital 55 Fruit St. GRB 1102 02114, Boston, MA, USA
  • Kelsey Witiuk Clinical Research Assistant Ottawa Hospital Research Institute 501 Smyth Rd. Box 201B Ottawa, ON, K1H 8L6
  • Rodney H. Breau Associate Scientist, Ottawa Hospital Research Institute Surgical Oncology, Division of Urology, University of Ottawa 501 Smyth Rd, Ottawa, ON, K1H 8L6, (Tel) 613-737-8899 ext. 73019 (Fax) 613-739-6842

DOI:

https://doi.org/10.5489/cuaj.1737

Keywords:

prostate cancer, biopsy, Gleason sum, Gleason grade, prostatectomy

Abstract

Introduction: We review a subset of men who had discordant prostate biopsy sums and were treated with radical prostatectomy.

Methods: Consecutive patients treated with radical prostatectomy at The Ottawa Hospital between 2000 and 2012 were reviewed. Those with at least 1 prostate biopsy core of Gleason sum ≥8 and at least 1 prostate biopsy core of Gleason sum ≤7 cancer were included.

Results: Of the 764 radical prostatectomies, 661 (87%) were eligible for the study and 35 (5%) met inclusion criteria. Of these, only 16 (46%) had prostatectomy Gleason sum of ≥8. When the highest biopsy core was Gleason sum 8 (n = 24), only 7 (29%) had a prostatectomy Gleason sum ≥8. When the highest biopsy core was Gleason 9 (n = 11), 9 (82%) had a prostatectomy Gleason sum ≥8 (relative risk [RR] 2.8; p = 0.004). Patients with clinical T3 tumours were at higher risk of Gleason sum ≥8 compared to cT1 patients (RR 3.7; p = 0.008). Patient age (p = 0.89), preoperative prostate-specific antigen (p = 0.34), prostate volume (p = 0.86), number of biopsy cores (p = 0.18), and proportion of biopsy cores with cancer (p = 0.96) were not strongly associated with risk of prostatectomy Gleason sum ≥8.

Conclusion: These data should be considered when assigning patients into prognostic risk categories based on prostate biopsy information. Further study to verify our findings using larger samples is warranted.

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Published

2014-07-18

How to Cite

Heimrath, O. P., Kos, Z., Belanger, E. C., Cagiannos, I., Morash, C., Gerridzen, R. G., Lavallee, L., Preston, M. A., Witiuk, K., & Breau, R. H. (2014). Predicting the Gleason sum of a patient with a prostate biopsy core Gleason ≤7 and a prostate biopsy core Gleason ≥8. Canadian Urological Association Journal, 8(7-8), e476–80. https://doi.org/10.5489/cuaj.1737

Issue

Vol. 8 No. 7-8 (2014): CUAJ July

Section

Original Research

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