AIM: There is increasing evidence of Gleason score (GS) drift in prostatic core biopsies over the last 2 decades.
The ProtecT study is a randomised controlled study and it provides an excellent cohort to study the effect of time, PSA level, perineural invasion, tumour length and age on GS.
METHODS AND RESULTS: The ProtecT study recruited men in the UK between 1999 and 2010. The Gleason scores were grouped into four categories ≤ 3+3, 3+4, 4+3 and ≥4+4 for analysis. Data from England between 2000 and 2012 were also available. A total of 3282 biopsies containing cancer were analyzed. For each year of the ProtecT study, the odds of being diagnosed with a higher GS category increased by 4.9%. Higher GS was also associated with perineural invasion, increasing tumour length, age and PSA level. Whilst biopsy GS was incomplete from England it also showed a marked decrease in GS 5 and 6 tumours over the same period.
CONCLUSION: There was GS drift from 3+3 to 3+4 with time in the ProtecT study, but there appeared to be no significant change in percentage of GS 4+3 or higher. This drift was less dramatic when compared to GS in the rest of England.
Written by:
Oxley J, Simpkin A, Goepel J, Varma M, Griffiths D, Grigor K, Mayer N, Warren A, Deshmukh N, Bhattarai S, Dormer J, Hounsome L, Adamczyk L, Metcalfe C, Lane JA, Davis M, Donovan JL, Neal DE, Hamdy FC. Are you the author?
Department of Cellular Pathology, Southmead Hospital, Bristol, UK.
Reference: Histopathology. 2014 Sep 17. Epub ahead of print.
doi: 10.1111/his.12549
PubMed Abstract
PMID: 25231130