Gleason 5+4 has worse oncological and pathological outcomes compared with Gleason 4+5: Significance of Gleason 5 pattern

Sey Kiat Lim, Kwang Hyun Kim, Tae Young Shin, Byungha Chung, Sung Joon Hong, Youngdeuk Choi, KoonHo Rha

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The purpose of this study was to evaluate the pathological and oncological significance of Gleason (G) 5 pattern in high-grade PCa after robotic-assisted radical prostatectomy (RARP). Materials and Methods: From a cohort of 1,046 men, 159 post-RARP patients by a single surgeon with pathological G8 (N = 79) and G9 (N = 80) met our inclusion criteria. G9 cancers were sub-stratified into G4+5 (N = 58) and G5+4 (N = 22). Clinical and pathological outcomes were evaluated with the t test or Mann-Whitney U test for continuous variables and the Pearson χ 2 test for categorical variables. The Kaplan-Meier method was used to estimate the biochemical recurrence-free survival (BCRFS), and survival curves were compared using the log-rank test. Multivariate analysis was performed with Cox regression analysis. Results: Baseline characteristics across all subgroups were similar except for number of positive cores on biopsy. There was a trend toward worse pathological and oncological outcomes in G9 cancers when compared with G8, although only tumor volume (TV), extracapsular extension (ECE) of tumor and lymph nodes involvement (LNI) achieved statistical significance. G4+5 PCa were statistically more likely to have ECE and a higher TV than G4+4 although the BCRFS were not significantly different. G5+4 cancers were associated with a significantly higher proportion of patients with LNI and had a statistically significant poorer BCRFS compared with G4+5 patients. Conclusions: Oncological and pathological outcomes of G8 were significantly better than G9 and merited distinction between them. G5+4 harbors a much poorer BCRFS compared with G4+5, and hence we suggest considerations for immediate adjuvant treatments.

Original languageEnglish
Pages (from-to)3127-3132
Number of pages6
JournalAnnals of Surgical Oncology
Volume20
Issue number9
DOIs
Publication statusPublished - 2013 Sep 1

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Survival
Recurrence
Robotics
Prostatectomy
Tumor Burden
Neoplasms
Lymph Nodes
Nonparametric Statistics
Multivariate Analysis
Regression Analysis
Biopsy
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

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title = "Gleason 5+4 has worse oncological and pathological outcomes compared with Gleason 4+5: Significance of Gleason 5 pattern",
abstract = "Background: The purpose of this study was to evaluate the pathological and oncological significance of Gleason (G) 5 pattern in high-grade PCa after robotic-assisted radical prostatectomy (RARP). Materials and Methods: From a cohort of 1,046 men, 159 post-RARP patients by a single surgeon with pathological G8 (N = 79) and G9 (N = 80) met our inclusion criteria. G9 cancers were sub-stratified into G4+5 (N = 58) and G5+4 (N = 22). Clinical and pathological outcomes were evaluated with the t test or Mann-Whitney U test for continuous variables and the Pearson χ 2 test for categorical variables. The Kaplan-Meier method was used to estimate the biochemical recurrence-free survival (BCRFS), and survival curves were compared using the log-rank test. Multivariate analysis was performed with Cox regression analysis. Results: Baseline characteristics across all subgroups were similar except for number of positive cores on biopsy. There was a trend toward worse pathological and oncological outcomes in G9 cancers when compared with G8, although only tumor volume (TV), extracapsular extension (ECE) of tumor and lymph nodes involvement (LNI) achieved statistical significance. G4+5 PCa were statistically more likely to have ECE and a higher TV than G4+4 although the BCRFS were not significantly different. G5+4 cancers were associated with a significantly higher proportion of patients with LNI and had a statistically significant poorer BCRFS compared with G4+5 patients. Conclusions: Oncological and pathological outcomes of G8 were significantly better than G9 and merited distinction between them. G5+4 harbors a much poorer BCRFS compared with G4+5, and hence we suggest considerations for immediate adjuvant treatments.",
author = "Lim, {Sey Kiat} and Kim, {Kwang Hyun} and Shin, {Tae Young} and Byungha Chung and Hong, {Sung Joon} and Youngdeuk Choi and KoonHo Rha",
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Gleason 5+4 has worse oncological and pathological outcomes compared with Gleason 4+5 : Significance of Gleason 5 pattern. / Lim, Sey Kiat; Kim, Kwang Hyun; Shin, Tae Young; Chung, Byungha; Hong, Sung Joon; Choi, Youngdeuk; Rha, KoonHo.

In: Annals of Surgical Oncology, Vol. 20, No. 9, 01.09.2013, p. 3127-3132.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Gleason 5+4 has worse oncological and pathological outcomes compared with Gleason 4+5

T2 - Significance of Gleason 5 pattern

AU - Lim, Sey Kiat

AU - Kim, Kwang Hyun

AU - Shin, Tae Young

AU - Chung, Byungha

AU - Hong, Sung Joon

AU - Choi, Youngdeuk

AU - Rha, KoonHo

PY - 2013/9/1

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N2 - Background: The purpose of this study was to evaluate the pathological and oncological significance of Gleason (G) 5 pattern in high-grade PCa after robotic-assisted radical prostatectomy (RARP). Materials and Methods: From a cohort of 1,046 men, 159 post-RARP patients by a single surgeon with pathological G8 (N = 79) and G9 (N = 80) met our inclusion criteria. G9 cancers were sub-stratified into G4+5 (N = 58) and G5+4 (N = 22). Clinical and pathological outcomes were evaluated with the t test or Mann-Whitney U test for continuous variables and the Pearson χ 2 test for categorical variables. The Kaplan-Meier method was used to estimate the biochemical recurrence-free survival (BCRFS), and survival curves were compared using the log-rank test. Multivariate analysis was performed with Cox regression analysis. Results: Baseline characteristics across all subgroups were similar except for number of positive cores on biopsy. There was a trend toward worse pathological and oncological outcomes in G9 cancers when compared with G8, although only tumor volume (TV), extracapsular extension (ECE) of tumor and lymph nodes involvement (LNI) achieved statistical significance. G4+5 PCa were statistically more likely to have ECE and a higher TV than G4+4 although the BCRFS were not significantly different. G5+4 cancers were associated with a significantly higher proportion of patients with LNI and had a statistically significant poorer BCRFS compared with G4+5 patients. Conclusions: Oncological and pathological outcomes of G8 were significantly better than G9 and merited distinction between them. G5+4 harbors a much poorer BCRFS compared with G4+5, and hence we suggest considerations for immediate adjuvant treatments.

AB - Background: The purpose of this study was to evaluate the pathological and oncological significance of Gleason (G) 5 pattern in high-grade PCa after robotic-assisted radical prostatectomy (RARP). Materials and Methods: From a cohort of 1,046 men, 159 post-RARP patients by a single surgeon with pathological G8 (N = 79) and G9 (N = 80) met our inclusion criteria. G9 cancers were sub-stratified into G4+5 (N = 58) and G5+4 (N = 22). Clinical and pathological outcomes were evaluated with the t test or Mann-Whitney U test for continuous variables and the Pearson χ 2 test for categorical variables. The Kaplan-Meier method was used to estimate the biochemical recurrence-free survival (BCRFS), and survival curves were compared using the log-rank test. Multivariate analysis was performed with Cox regression analysis. Results: Baseline characteristics across all subgroups were similar except for number of positive cores on biopsy. There was a trend toward worse pathological and oncological outcomes in G9 cancers when compared with G8, although only tumor volume (TV), extracapsular extension (ECE) of tumor and lymph nodes involvement (LNI) achieved statistical significance. G4+5 PCa were statistically more likely to have ECE and a higher TV than G4+4 although the BCRFS were not significantly different. G5+4 cancers were associated with a significantly higher proportion of patients with LNI and had a statistically significant poorer BCRFS compared with G4+5 patients. Conclusions: Oncological and pathological outcomes of G8 were significantly better than G9 and merited distinction between them. G5+4 harbors a much poorer BCRFS compared with G4+5, and hence we suggest considerations for immediate adjuvant treatments.

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