title: Gleason sum upgrading between biopsy and radical prostatectomy in Chinese population: Updated nomograms.
abstract: BACKGROUND
  To assess the risk factors of Gleason sum upgrading between biopsy and radical prostatectomy (RP) and update the nomogram for the prediction of Gleason sum upgrading.
  
  
  METHODS
  The study cohort consisted of 237 Chinese prostate adenocarcinoma patients who underwent 10-core prostate biopsy and subsequently received RP in Huashan Hospital from February 2011 to May 2015. The main outcome of our study was Gleason sum upgrading between biopsy and RP pathology. Univariate and multivariate logistic regression models were conducted to explore the potential predictors, and ultimately to build the nomograms. The prediction model was further evaluated for its ability to predict significant upgrading in patients with biopsy Gleason sum<8.
  
  
  RESULTS
  In the main cohort of all the patients, Gleason sum upgrading was observed in 62 (26.16%) patients. The pre-operative prostate-specific antigen (PSA) level, biopsy Gleason sum, and digital rectal examination were used in building the nomogram, which was validated internally with a bootstrap-corrected concordance index of 0.787. In the sub-cohort of 115 patients with standardized biopsy details, Gleason sum upgrading was observed in 31 (26.96%) patients. The pre-operative PSA level, biopsy Gleason sum, and number of positive cores were used in the nomogram, which was also validated internally with a bootstrap-corrected concordance index of 0.833. These two nomograms both demonstrated satisfactory statistical performance for predicting significant upgrading.
  
  
  CONCLUSIONS
  Updated nomograms to predict Gleason sum upgrading in Chinese population between biopsy and RP were developed, demonstrating good statistical performance upon internal validation.
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: H
authors: H
authors: Xu
authors: Departamento de Urología, The First Affiliated Hospital of Xiamen University, Fujian, PR, China.
authors: P D
authors: PD
authors: Bai
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: M B
authors: MB
authors: Hu
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: S H
authors: SH
authors: Mao
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: W H
authors: WH
authors: Zhu
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: J M
authors: JM
authors: Hu
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: S H
authors: SH
authors: Liu
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: T
authors: T
authors: Yang
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: J Y
authors: JY
authors: Hou
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: Y
authors: Y
authors: Hu
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China.
authors: Q
authors: Q
authors: Ding
authors: Departamento de Urología, Hospital Huashan, Universidad Fudan, Shanghai, PR, China. Electronic address: haowen_jiang@126.com.
authors: H W
authors: HW
authors: Jiang
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001706:Biopsy; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D049451:Nomograms; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: Adenocarcinoma de próstata; Biopsia; Biopsy; Gleason score; Nomogram; Nomograma; Prostate adenocarcinoma; Prostatectomía radical; Puntuación de Gleason; Radical prostatectomy