title: Clinical significance of a large difference (≥ 2 points) between biopsy and post-prostatectomy pathological Gleason scores in patients with prostate cancer.
abstract: We investigated the clinical significance of large difference (≥ 2 points) between biopsy-derived (bGS) and post-prostatectomy Gleason scores (pGS). At 14 medical centers in Korea, 1,582 men who underwent radical prostatectomy for prostate cancer were included. According to the difference between bGS and pGS, the patients were divided into three groups: A (decreased in pGS ≥ 2, n = 30), B (changed in pGS ≤ 1, n = 1,361; control group), and C (increased in pGS ≥ 2, n = 55). We evaluated various clinicopathological factors of prostate cancer and hazards for biochemical failure. Group A showed significantly higher mean maximal percentage of cancer in the positive cores (max%) and pathological T stage than control. In group C, the number of biopsy core was significantly smaller, however, tumor volume and max% were significantly higher and more positive biopsy cores were presented than control. Worse pathological stage and more margin-positive were observed in group A and C than in control. Hazard ratio for biochemical failure was also higher in group A and C (P = 0.001). However, the groups were not independent factors in multivariate analysis. In conclusion, large difference between bGS and pGS shows poor prognosis even in the decreased group. However it is not an independent prognostic factor for biochemical failure.
authors.affiliation: Department of Urology, College of Medicine, Hallym University, Chuncheon, Korea.
authors.forename: Changhee
authors.initials: C
authors.lastname: Yoo
authors.forename: Cheol Young
authors.initials: CY
authors.lastname: Oh
authors.forename: Jin Seon
authors.initials: JS
authors.lastname: Cho
authors.forename: Cheryn
authors.initials: C
authors.lastname: Song
authors.forename: Seong Il
authors.initials: SI
authors.lastname: Seo
authors.forename: Hanjong
authors.initials: H
authors.lastname: Ahn
authors.forename: Tae-Kon
authors.initials: TK
authors.lastname: Hwang
authors.forename: Jun
authors.initials: J
authors.lastname: Cheon
authors.forename: Kang Hyun
authors.initials: KH
authors.lastname: Lee
authors.forename: Tae Gyun
authors.initials: TG
authors.lastname: Kwon
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Jung
authors.forename: Moon Kee
authors.initials: MK
authors.lastname: Chung
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Hyun Moo
authors.initials: HM
authors.lastname: Lee
authors.forename: Eun Sik
authors.initials: ES
authors.lastname: Lee
authors.forename: Young Deuk
authors.initials: YD
authors.lastname: Choi
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Wun-Jae
authors.initials: WJ
authors.lastname: Kim
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Han Yong
authors.initials: HY
authors.lastname: Choi
mesh_terms: D000367:Age Factors; D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D012720:Severity of Illness Index