Prognostic Significance of Gleason Score Discrepancies between Needle Biopsy and Radical Prostatectomy

Michael Müntener, Jonathan Ira Epstein, David J. Hernandez, Mark L. Gonzalgo, Leslie Mangold, Elizabeth Humphreys, Patrick Walsh, Alan Wayne Partin, Matthew E. Nielsen

Research output: Contribution to journalArticle

Abstract

Objectives: Discordance between the Gleason score (GS) on needle biopsy (NB) and the GS of the radical prostatectomy (RP) specimen is a common finding. The objective of this study was to evaluate the prognostic significance of these discrepancies with respect to outcomes following RP. Methods: In the study, 6625 men treated by RP were categorized as having NB=RP (68.8%), NBRP (6.2%) GS, and stratified for analyses into RP GS groups. The Kaplan-Meier method was used to analyze differences in biochemical recurrence-free survival (BRFS), and multivariate Cox analyses were performed to estimate the independent relative risk of progression associated with GS discrepancies. Results: Across multiple RP GS strata (3+4, 7, 8, 8-10), patients with a lower NB GS experienced significantly better BRFS than patients with equal NB and RP GS (all p <0.05). NBRP GS had poorer BRFS than patients with NB=RP GS across multiple RP GS strata (≤3+3, 3+4, 7; all p <0.05). NB>RP GS was independently associated with worse (pooled HR, 1.91, p <0.001) BRFS probabilities, within and across RP GS strata. Conclusions: Our data suggest that the GS of the NB adds additional prognostic value to the RP GS in a consistent manner that may be applicable to strategies of risk stratification and patient counseling after surgery.

Original languageEnglish (US)
Pages (from-to)767-776
Number of pages10
JournalEuropean Urology
Volume53
Issue number4
DOIs
StatePublished - Apr 2008

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Neoplasm Grading
Needle Biopsy
Prostatectomy
Recurrence
Survival
Counseling
Multivariate Analysis

Keywords

  • Gleason score
  • Needle biopsy
  • Prostate cancer
  • PSA recurrence
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Müntener, M., Epstein, J. I., Hernandez, D. J., Gonzalgo, M. L., Mangold, L., Humphreys, E., ... Nielsen, M. E. (2008). Prognostic Significance of Gleason Score Discrepancies between Needle Biopsy and Radical Prostatectomy. European Urology, 53(4), 767-776. https://doi.org/10.1016/j.eururo.2007.11.016

Prognostic Significance of Gleason Score Discrepancies between Needle Biopsy and Radical Prostatectomy. / Müntener, Michael; Epstein, Jonathan Ira; Hernandez, David J.; Gonzalgo, Mark L.; Mangold, Leslie; Humphreys, Elizabeth; Walsh, Patrick; Partin, Alan Wayne; Nielsen, Matthew E.

In: European Urology, Vol. 53, No. 4, 04.2008, p. 767-776.

Research output: Contribution to journalArticle

Müntener, Michael ; Epstein, Jonathan Ira ; Hernandez, David J. ; Gonzalgo, Mark L. ; Mangold, Leslie ; Humphreys, Elizabeth ; Walsh, Patrick ; Partin, Alan Wayne ; Nielsen, Matthew E. / Prognostic Significance of Gleason Score Discrepancies between Needle Biopsy and Radical Prostatectomy. In: European Urology. 2008 ; Vol. 53, No. 4. pp. 767-776.
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AU - Epstein, Jonathan Ira

AU - Hernandez, David J.

AU - Gonzalgo, Mark L.

AU - Mangold, Leslie

AU - Humphreys, Elizabeth

AU - Walsh, Patrick

AU - Partin, Alan Wayne

AU - Nielsen, Matthew E.

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N2 - Objectives: Discordance between the Gleason score (GS) on needle biopsy (NB) and the GS of the radical prostatectomy (RP) specimen is a common finding. The objective of this study was to evaluate the prognostic significance of these discrepancies with respect to outcomes following RP. Methods: In the study, 6625 men treated by RP were categorized as having NB=RP (68.8%), NBRP (6.2%) GS, and stratified for analyses into RP GS groups. The Kaplan-Meier method was used to analyze differences in biochemical recurrence-free survival (BRFS), and multivariate Cox analyses were performed to estimate the independent relative risk of progression associated with GS discrepancies. Results: Across multiple RP GS strata (3+4, 7, 8, 8-10), patients with a lower NB GS experienced significantly better BRFS than patients with equal NB and RP GS (all p <0.05). NBRP GS had poorer BRFS than patients with NB=RP GS across multiple RP GS strata (≤3+3, 3+4, 7; all p <0.05). NB>RP GS was independently associated with worse (pooled HR, 1.91, p <0.001) BRFS probabilities, within and across RP GS strata. Conclusions: Our data suggest that the GS of the NB adds additional prognostic value to the RP GS in a consistent manner that may be applicable to strategies of risk stratification and patient counseling after surgery.

AB - Objectives: Discordance between the Gleason score (GS) on needle biopsy (NB) and the GS of the radical prostatectomy (RP) specimen is a common finding. The objective of this study was to evaluate the prognostic significance of these discrepancies with respect to outcomes following RP. Methods: In the study, 6625 men treated by RP were categorized as having NB=RP (68.8%), NBRP (6.2%) GS, and stratified for analyses into RP GS groups. The Kaplan-Meier method was used to analyze differences in biochemical recurrence-free survival (BRFS), and multivariate Cox analyses were performed to estimate the independent relative risk of progression associated with GS discrepancies. Results: Across multiple RP GS strata (3+4, 7, 8, 8-10), patients with a lower NB GS experienced significantly better BRFS than patients with equal NB and RP GS (all p <0.05). NBRP GS had poorer BRFS than patients with NB=RP GS across multiple RP GS strata (≤3+3, 3+4, 7; all p <0.05). NB>RP GS was independently associated with worse (pooled HR, 1.91, p <0.001) BRFS probabilities, within and across RP GS strata. Conclusions: Our data suggest that the GS of the NB adds additional prognostic value to the RP GS in a consistent manner that may be applicable to strategies of risk stratification and patient counseling after surgery.

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KW - Needle biopsy

KW - Prostate cancer

KW - PSA recurrence

KW - Radical prostatectomy

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