Gleason score 7 prostate cancer on needle biopsy: Is the prognostic difference in gleason scores 4 + 3 and 3 + 4 independent of the number of involved cores?

Danil V. Makarov, Harriete Sanderson, Alan Wayne Partin, Jonathan Ira Epstein

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Abstract

Purpose: We addressed whether Gleason score 3 + 4 = 7 and 4 + 3 = 7 cancers on needle biopsy behave differently and whether this behavior is independent of the number of cores involved by cancer. If it is not an independent predictor of prognosis, one may report Gleason score 7 cancer with the number of positive cores without regard to whether the primary pattern was 3 or 4. This practice would remove a source of poor interobserver reproducibility when grading prostate cancer on needle biopsy. Materials and Methods: We identified 537 patients with Gleason score 7 tumors on biopsy. The results of patient preoperative digital rectal examination, serum prostate specific antigen (PSA) measurement and age were used to predict 4 outcomes based on assessment of the corresponding radical prostatectomy specimens, including 1) pathological stage (organ confined, focal extraprostatic extension, nonfocal extraprostatic extension or seminal vesicle-lymph node involvement), 2) organ confinement (yes/no), 3) Gleason score and 4) surgical margin status (positive/negative). Results: Multivariate regression of postoperative Gleason score groups against all 5 input variables (3 + 4 versus 4 + 3, number of positive cores, PSA, age and digital rectal examination) yielded a statistically significant positive correlation with preoperative PSA (p

Original languageEnglish (US)
Pages (from-to)2440-2442
Number of pages3
JournalJournal of Urology
Volume167
Issue number6
StatePublished - 2002

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Neoplasm Grading
Needle Biopsy
Prostatic Neoplasms
Prostate-Specific Antigen
Digital Rectal Examination
Neoplasms
Seminal Vesicles
Prostatectomy
Lymph Nodes
Biopsy
Serum

Keywords

  • Biopsy
  • Neoplasm staging
  • Prognosis
  • Prostate
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

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title = "Gleason score 7 prostate cancer on needle biopsy: Is the prognostic difference in gleason scores 4 + 3 and 3 + 4 independent of the number of involved cores?",
abstract = "Purpose: We addressed whether Gleason score 3 + 4 = 7 and 4 + 3 = 7 cancers on needle biopsy behave differently and whether this behavior is independent of the number of cores involved by cancer. If it is not an independent predictor of prognosis, one may report Gleason score 7 cancer with the number of positive cores without regard to whether the primary pattern was 3 or 4. This practice would remove a source of poor interobserver reproducibility when grading prostate cancer on needle biopsy. Materials and Methods: We identified 537 patients with Gleason score 7 tumors on biopsy. The results of patient preoperative digital rectal examination, serum prostate specific antigen (PSA) measurement and age were used to predict 4 outcomes based on assessment of the corresponding radical prostatectomy specimens, including 1) pathological stage (organ confined, focal extraprostatic extension, nonfocal extraprostatic extension or seminal vesicle-lymph node involvement), 2) organ confinement (yes/no), 3) Gleason score and 4) surgical margin status (positive/negative). Results: Multivariate regression of postoperative Gleason score groups against all 5 input variables (3 + 4 versus 4 + 3, number of positive cores, PSA, age and digital rectal examination) yielded a statistically significant positive correlation with preoperative PSA (p",
keywords = "Biopsy, Neoplasm staging, Prognosis, Prostate, Prostatic neoplasms",
author = "Makarov, {Danil V.} and Harriete Sanderson and Partin, {Alan Wayne} and Epstein, {Jonathan Ira}",
year = "2002",
language = "English (US)",
volume = "167",
pages = "2440--2442",
journal = "Journal of Urology",
issn = "0022-5347",
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TY - JOUR

T1 - Gleason score 7 prostate cancer on needle biopsy

T2 - Is the prognostic difference in gleason scores 4 + 3 and 3 + 4 independent of the number of involved cores?

AU - Makarov, Danil V.

AU - Sanderson, Harriete

AU - Partin, Alan Wayne

AU - Epstein, Jonathan Ira

PY - 2002

Y1 - 2002

N2 - Purpose: We addressed whether Gleason score 3 + 4 = 7 and 4 + 3 = 7 cancers on needle biopsy behave differently and whether this behavior is independent of the number of cores involved by cancer. If it is not an independent predictor of prognosis, one may report Gleason score 7 cancer with the number of positive cores without regard to whether the primary pattern was 3 or 4. This practice would remove a source of poor interobserver reproducibility when grading prostate cancer on needle biopsy. Materials and Methods: We identified 537 patients with Gleason score 7 tumors on biopsy. The results of patient preoperative digital rectal examination, serum prostate specific antigen (PSA) measurement and age were used to predict 4 outcomes based on assessment of the corresponding radical prostatectomy specimens, including 1) pathological stage (organ confined, focal extraprostatic extension, nonfocal extraprostatic extension or seminal vesicle-lymph node involvement), 2) organ confinement (yes/no), 3) Gleason score and 4) surgical margin status (positive/negative). Results: Multivariate regression of postoperative Gleason score groups against all 5 input variables (3 + 4 versus 4 + 3, number of positive cores, PSA, age and digital rectal examination) yielded a statistically significant positive correlation with preoperative PSA (p

AB - Purpose: We addressed whether Gleason score 3 + 4 = 7 and 4 + 3 = 7 cancers on needle biopsy behave differently and whether this behavior is independent of the number of cores involved by cancer. If it is not an independent predictor of prognosis, one may report Gleason score 7 cancer with the number of positive cores without regard to whether the primary pattern was 3 or 4. This practice would remove a source of poor interobserver reproducibility when grading prostate cancer on needle biopsy. Materials and Methods: We identified 537 patients with Gleason score 7 tumors on biopsy. The results of patient preoperative digital rectal examination, serum prostate specific antigen (PSA) measurement and age were used to predict 4 outcomes based on assessment of the corresponding radical prostatectomy specimens, including 1) pathological stage (organ confined, focal extraprostatic extension, nonfocal extraprostatic extension or seminal vesicle-lymph node involvement), 2) organ confinement (yes/no), 3) Gleason score and 4) surgical margin status (positive/negative). Results: Multivariate regression of postoperative Gleason score groups against all 5 input variables (3 + 4 versus 4 + 3, number of positive cores, PSA, age and digital rectal examination) yielded a statistically significant positive correlation with preoperative PSA (p

KW - Biopsy

KW - Neoplasm staging

KW - Prognosis

KW - Prostate

KW - Prostatic neoplasms

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