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J Cancer Res Clin Oncol. 2017 Nov;143(11):2393-2400. doi: 10.1007/s00432-017-2502-7. Epub 2017 Aug 19.

Impact of Gleason score on biochemical recurrence in patients with pT3aN0/Nx prostate cancer with positive surgical margins: a multicenter study from the Prostate Cancer Research Committee.

Author information

1
Department of Urology, School of Medicine, Ewha Womans University, Seoul, Korea.
2
Department of Urology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
3
Department of Urology, Guro Hospital, Korea University, Seoul, Korea.
4
Department of Urology, Bundang Hospital, Seoul National University, Seongnam, Korea.
5
Department of Urology, Seoul National University Hospital, Seoul, Korea.
6
Department of Urology, College of Medicine, Hallym University, Chuncheon, Korea.
7
Department of Urology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea. hjahn@amc.seoul.kr.
8
Department of Urology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea. seongsoojeon@gmail.com.

Abstract

PURPOSE:

Oncologic outcomes of patients with pT3aN0/Nx prostate cancer (PCa) with positive surgical margins (PSM) after radical prostatectomy (RP) are heterogeneous. We investigated the impact of Gleason score (GS) on biochemical recurrence (BCR) in these patients.

METHODS:

A retrospective, multicenter study was performed on 795 patients with pT3aN0/Nx PCa with PSM after RP between January 2006 and December 2014. Clinicopathologic characteristics of patients were examined and onset of BCR was identified. Kaplan-Meier survival analysis was used to illustrate BCR-free survival (BFS) and Cox proportional hazard models were applied to identify factors predicting BCR.

RESULTS:

During the mean follow-up period of 63.9 months, BCR was identified in 274 (34.5%) patients. The 5-year BFS was 56.6% in all patients. In multivariate analysis, pathologic GS was the only significant prognostic factor for BCR in patients with pT3aN0/Nx PCa with PSM (GS 6 vs. GS 7 (3 + 4), P = 0.047; vs. GS 7 (4 + 3), P = 0.007, and vs. GS 8-10, P < 0.001). When patients were stratified according to GS, 5-year BFS was 78.6% in GS 6, 66.2% in GS 7 (3 + 4), 51.1% in GS 7 (4 + 3) and 35.5% in GS 8-10.

CONCLUSIONS:

In patients with pT3aN0/Nx with PSM after RP, pathologic GS is the sole independent predictor for risk stratification of BCR. These findings might be used to determine the risk and timing of BCR and to help counsel patients regarding treatment strategy and prognosis of disease on an individual basis.

KEYWORDS:

Biochemical recurrence; Gleason score; Positive surgical margin; Prognostic factor; Prostate cancer

PMID:
28823006
DOI:
10.1007/s00432-017-2502-7
[Indexed for MEDLINE]

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