Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer

Bibliographic Details
Title: Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer
Authors: Benedikt Hoeh, Rocco Flammia, Lukas Hohenhorst, Gabriele Sorce, Francesco Chierigo, Zhe Tian, Fred Saad, Michele Gallucci, Alberto Briganti, Carlo Terrone, Shahrokh F. Shariat, Markus Graefen, Derya Tilki, Luis A. Kluth, Philipp Mandel, Felix K.H. Chun, Pierre I. Karakiewicz
Source: Prostate International, Vol 10, Iss 1, Pp 21-27 (2022)
Publisher Information: Elsevier, 2022.
Publication Year: 2022
Collection: LCC:Diseases of the genitourinary system. Urology
Subject Terms: Downgrading, Intermediate-risk, Prostate cancer, Single positive core biopsy, Upgrading, Diseases of the genitourinary system. Urology, RC870-923
More Details: Background: Up- and/or downgrading rates in single intermediate-risk positive biopsy core are unknown. Methods: We identified single intermediate-risk (Gleason grade group (GGG) 2/GGG3) positive biopsy core prostate cancer patients (≤ cT2c and PSA ≤ 20 ng/mL) within the Surveillance, Epidemiology, and End Results (SEER) database (2010–2015). Subsequently, separate uni- and multivariable logistic regression models tested for independent predictors of up- and downgrading. Results: Of 1,328 assessable patients with single core positive intermediate-risk prostate cancer at biopsy, 972 (73%) harbored GGG2 versus 356 (27%) harbored GGG3. Median PSA (5.5 vs 5.7; p = 0.3), median age (62 vs 63 years; p = 0.07) and cT1-stage (77 vs 75%; p = 0.3) did not differ between GGG2 and GGG3 patients. Of individuals with single GGG2 positive biopsy core, 191 (20%) showed downgrading to GGG1 versus 35 (4%) upgrading to GGG4 or GGG5 at RP. Of individuals with single GGG3 positive biopsy core, 36 (10%) showed downgrading to GGG1 versus 42 (12%) significant upgrading to GGG4 or GGG5 at RP. In multivariable logistic regression models, elevated PSA (10–20 ng/mL) was an independent predictor of upgrading to GGG4/GGG5 in single GGG3 positive biopsy core patients (OR:2.89; 95%-CI: 1.31–6.11; p = 0.007). Conclusion: In single GGG2 positive biopsy core patients, downgrading was four times more often recorded compared to upgrading. Conversely, in single GGG3 positive biopsy core patients, up- and downgrading rates were comparable and should be expected in one out of ten patients.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2287-8882
Relation: http://www.sciencedirect.com/science/article/pii/S2287888222000046; https://doaj.org/toc/2287-8882
DOI: 10.1016/j.prnil.2022.01.004
Access URL: https://doaj.org/article/7f017d5f0e3a4b62a1a5363036dc60c4
Accession Number: edsdoj.7f017d5f0e3a4b62a1a5363036dc60c4
Database: Directory of Open Access Journals
More Details
ISSN:22878882
DOI:10.1016/j.prnil.2022.01.004
Published in:Prostate International
Language:English