Higher Prostate Weight Is Inversely Associated With Gleason Score Upgrading In Radical Prostatectomy Specimens

dc.creatorReis L.O.
dc.creatorZani E.L.
dc.creatorFreitas L.L.L.
dc.creatorDenardi F.
dc.creatorBillis A.
dc.date2013
dc.date2015-06-25T19:09:41Z
dc.date2015-11-26T15:07:44Z
dc.date2015-06-25T19:09:41Z
dc.date2015-11-26T15:07:44Z
dc.date.accessioned2018-03-28T22:18:09Z
dc.date.available2018-03-28T22:18:09Z
dc.identifier
dc.identifierAdvances In Urology. , v. , n. , p. - , 2013.
dc.identifier16876369
dc.identifier10.1155/2013/710421
dc.identifierhttp://www.scopus.com/inward/record.url?eid=2-s2.0-84888870478&partnerID=40&md5=a22271fd72d97dbec9ebbaa0925d2c02
dc.identifierhttp://www.repositorio.unicamp.br/handle/REPOSIP/88351
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/88351
dc.identifier2-s2.0-84888870478
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1257535
dc.descriptionBackground. Protective factors against Gleason upgrading and its impact on outcomes after surgery warrant better definition. Patients and Methods. Consecutive 343 patients were categorized at biopsy (BGS) and prostatectomy (PGS) as Gleason score, ≤6, 7, and ≥8; 94 patients (27.4%) had PSA recurrence, mean followup 80.2 months (median 99). Independent predictors of Gleason upgrading (logistic regression) and disease-free survival (DFS) (Kaplan-Meier, log-rank) were determined. Results. Gleason discordance was 45.7% (37.32% upgrading and 8.45% downgrading). Upgrading risk decreased by 2.4% for each 1 g of prostate weight increment, while it increased by 10.2% for every 1 ng/mL of PSA, 72.0% for every 0.1 unity of PSA density and was 21 times higher for those with BGS 7. Gleason upgrading showed increased clinical stage (P = 0.019), higher tumor extent (P = 0.009), extraprostatic extension (P = 0.04), positive surgical margins (P < 0.001), seminal vesicle invasion (P = 0.003), less "insignificant" tumors (P < 0.001), and also worse DFS, χ 2 = 4.28, df = 1, P = 0.039. However, when setting the final Gleason score (BGS ≤ 6 to PGS 7 versus BGS 7 to PGS 7), avoiding allocation bias, DFS impact is not confirmed, χ 2 = 0.40, df = 1, P = 0.530. Conclusions. Gleason upgrading is substantial and confers worse outcomes. Prostate weight is inversely related to upgrading and its protective effect warrants further evaluation. © 2013 Leonardo Oliveira Reis et al.
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dc.languageen
dc.publisher
dc.relationAdvances in Urology
dc.rightsaberto
dc.sourceScopus
dc.titleHigher Prostate Weight Is Inversely Associated With Gleason Score Upgrading In Radical Prostatectomy Specimens
dc.typeArtículos de revistas


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