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

Wan Song, Dong Hyeon Lee, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Hyun Moo Lee, Han Yong Choi, Jong Wook Kim, Sang Chul Lee, Seok Soo Byun, Chang Wook Jeong, Cheol Kwak, Jin Seon Cho, Hanjong Ahn, Seong Soo Jeon

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

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.

Original languageEnglish
Pages (from-to)2393-2400
Number of pages8
JournalJournal of Cancer Research and Clinical Oncology
Volume143
Issue number11
DOIs
StatePublished - 1 Nov 2017

Keywords

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

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