Gleason score biopsy undergrading (GSBU) can have an impact on the management and prognosis of patients with prostate cancer. We analyze the possible impact of time and other clinical and analytical factors in the appearance of GSBU in our series.
Ambispective, multicenter study of 1955 patients with localized prostate cancer undergoing radical prostatectomy between 2005 and 2018. Descriptive statistics and hypothesis testing are reported by univariate and multivariate analyses.
Mean age 63.69 (44-80) years, median PSA 8.70 ng / ml (1.23-99). GSBU was observed in 34.7% of the entire cohort. In 72.8% of the cases, the GSBU occurred in one consecutive Gleason score, with the progression from 3 + 3 to 3 + 4 being the most frequent (289 patients, 47.6%). Performing radical prostatectomy 90-180 days before or after the biopsy does not have an impact on its undergrading in any of the groups. In the univariate and multivariate analysis, the presence of tumor or pathological rectal examination in both lobes, the tumor load ≥50% of cylinders and a DPSA ≥0.20, showed independent discriminative capacity to select patients who presented GSBU.
The time from biopsy to radical prostatectomy did not show impact on GSBU. The number of affected cylinders, bilateral tumor and DPSA are easily accessible parameters that can help us select patients with greater probability of presenting GSBU.
Actas urologicas espanolas. 2019 Dec 13 [Epub ahead of print]
A J Virseda Rodríguez, S Marcos Asensio, M Herrero Polo, T Hernández Sanchez, A Sanz Ruiz, F García, F Vesga, E Gutiérrez, J M Serrano, J Calleja, J R Cortiñas, A Zamora, V Rodríguez, J H Amon Sesmero, R J Szczesniewski, S Valverde Martínez, C Polo López, L Gala, F Campanario, A Barcina, M A López Aramburu, I Moya, R Bermúdez, F Gómez Veiga
Servicio de Urología, Complejo Hospitalario Universitario de Salamanca, Salamanca, España. Electronic address: ., Servicio de Urología, Complejo Hospitalario Universitario de Salamanca, Salamanca, España., Servicio de Urología, Complejo Hospitalario Universitario de León, León, España., Servicio de Urología, Complejo Hospitalario Universitario de Burgos, Burgos, España., Servicio de Urología, Hospital Clínico Universitario de Valladolid, Valladolid, España., Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, España., Servicio de Urología, Hospital Santos Reyes, Aranda de Duero (Burgos), España., Servicio de Urología, Hospital Nuestra Señora de Sonsoles, Ávila, España., Servicio de Urología, Complejo Asistencial de Palencia, Palencia, España., Servicio de Urología, Hospital Santiago Apóstol, Miranda de Ebro (Burgos), España., Servicio de Urología, Complejo Asistencial de Segovia, Segovia, España.