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KMID : 0191120110260040507
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Journal of Korean Medical Science
2011 Volume.26 No. 4 p.507 ~ p.512
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Clinical Significance of a Large Difference (≥ 2 points) between Biopsy and Post-prostatectomy Pathological Gleason Scores in Patients with Prostate Cancer
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Yoo Chang-Hee
Oh Cheol-Young
Cho Jin-Seon
Song Che-Ryn
Seo Seong-Il
Ahn Han-Jong
Hwang Tae-Kon
Cheon Jun
Lee Kang-Hyun
Kwon Tae-Gyun
Jung Tae-Young
Chung Moon-Kee
Lee Sang-Eun
Lee Hyun-Moo
Lee Eun-Sik
Choi Young-Deuk
Chung Byung-Ha
Kim Hyung-Jin
Kim Wun-Jae
Byun Seok-Soo
Choi Han-Yong
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Abstract
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We investigated the clinical significance of large difference (≥ 2 points) between biopsy-derived (bGS) and post-prostatectomy Gleason scores (pGS). At 14 medical centers in Korea, 1,582 men who underwent radical prostatectomy for prostate cancer were included. According to the difference between bGS and pGS, the patients were divided into three groups: A (decreased in pGS ≥ 2, n = 30), B (changed in pGS ≤ 1, n = 1,361; control group), and C (increased in pGS ≥ 2, n = 55). We evaluated various clinicopathological factors of prostate cancer and hazards for biochemical failure. Group A showed significantly higher mean maximal percentage of cancer in the positive cores (max%) and pathological T stage than control. In group C, the number of biopsy core was significantly smaller, however, tumor volume and max% were significantly higher and more positive biopsy cores were presented than control. Worse pathological stage and more margin-positive were observed in group A and C than in control. Hazard ratio for biochemical failure was also higher in group A and C (P = 0.001). However, the groups were not independent factors in multivariate analysis. In conclusion, large difference between bGS and pGS shows poor prognosis even in the decreased group. However it is not an independent prognostic factor for biochemical failure.
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KEYWORD
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Prostatic Neoplasms, Gleason Score, Prognosis
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