Disease‐specific death and metastasis do not occur in patients with Gleason score ≤6 at radical prostatectomy
- 7 March 2015
- journal article
- Published by Wiley in BJU International
- Vol. 116 (2), 230-235
- https://doi.org/10.1111/bju.12879
Abstract
To assess the metastasis-free survival (MFS) and disease-specific survival (DSS) in men with Gleason score ≤6 prostate cancer at radical prostatectomy (RP). We included 1101 consecutive RP patients operated between March 1985 to July 2013 at a single institution. The outcome variables were MFS and DSS. The postoperative survival was estimated by the Kaplan-Meier method. The Gleason score distribution of the study population (1101 patients) was Gleason score ≤6 (449, 41%), Gleason score 3 + 4 = 7 (436, 40%), Gleason score 4 + 3 = 7 (99, 9%) and Gleason score 8-10 (117, 11%). The median (interquartile range) postoperative follow-up was 100 (48-150) months. During follow-up 197 men (18%) died, of whom 42 (3.8%) died from prostate cancer-related causes. In all, 19/1101 patients (1.7%) had documented lymph node metastasis at the time of RP: none with Gleason score ≤6, seven with Gleason score 3 + 4 = 7 (1.6%), six with Gleason score 4 + 3 = 7 (6.1%) and six with Gleason score 8-10 (5.1%). Distant metastasis occurred in 56/1101 patients (5.1%): none with Gleason score ≤6, 23 with Gleason score 3 + 4 = 7 (5.3%), 17 with Gleason score 4 + 3 = 7 (17%) and 16 with Gleason score 8-10 (14%). Disease-specific death, stratified per Gleason-score group was: none in ≤6, 16 (3.7%) in 3 + 4 = 7, 16 (16%) in 4 + 3 = 7 and 10 (8.5%) in 8-10 group. No metastasis or disease-specific death were seen in men with Gleason score ≤6 prostate cancer at RP, showing the negligible potential to metastasise in this large subgroup of patients with prostate cancer.Keywords
This publication has 20 references indexed in Scilit:
- Update on the Gleason grading systemAnnales de Pathologie, 2011
- Predicting 15-Year Prostate Cancer Specific Mortality After Radical ProstatectomyJournal of Urology, 2011
- Role of Prostate Specific Antigen and Immediate Confirmatory Biopsy in Predicting Progression During Active Surveillance for Low Risk Prostate CancerJournal of Urology, 2011
- Careful Selection and Close Monitoring of Low-Risk Prostate Cancer Patients on Active Surveillance Minimizes the Need for TreatmentEuropean Urology, 2010
- Time Trends and Local Variation in Primary Treatment of Localized Prostate CancerJournal of Clinical Oncology, 2010
- Gleason grading of prostatic adenocarcinoma with glomeruloid features on needle biopsyHuman Pathology, 2009
- Outcomes of Men with Screen-Detected Prostate Cancer Eligible for Active Surveillance Who Were Managed ExpectantlyEuropean Urology, 2009
- Predicting the Probability of Deferred Radical Treatment for Localised Prostate Cancer Managed by Active SurveillanceEuropean Urology, 2008
- Natural History of Pathologically Organ-Confined (pT2), Gleason Score 6 or Less, Prostate Cancer After Radical ProstatectomyUrology, 2008
- Should We Replace the Gleason Score with the Amount of High-Grade Prostate Cancer?European Urology, 2007