Presence of high grade tertiary Gleason pattern upgrades the Gleason sum score and is inversely associated with biochemical recurrence-free survival

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dc.authorid0000-0002-5947-947X
dc.authorscopusid23052928300
dc.authorscopusid24079868400
dc.authorscopusid6701523452
dc.authorscopusid55901282200
dc.authorscopusid55440203400
dc.authorscopusid23397927000
dc.authorscopusid7006257566
dc.authorwosidBOZKURT, SUHEYLA UYAR uyar/A-8912-2016
dc.authorwosidTürkeri, Levent N./W-9283-2018
dc.contributor.authorTürker, Polat
dc.contributor.authorBaş, Emine
dc.contributor.authorBozkurt, Süheyla
dc.contributor.authorGünlüsoy, Bülent
dc.contributor.authorSezgin, Arsenal
dc.contributor.authorPostacı, Hakan
dc.contributor.authorTürkeri, Levent
dc.date.accessioned2022-05-11T14:36:57Z
dc.date.available2022-05-11T14:36:57Z
dc.date.issued2013
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractObjectives: Tumor heterogeneity is a common finding and led to realization of a tertiary Gleason component (TGC) in prostate cancer. In an attempt to further investigate its prognostic value, we analyzed the association of tertiary Gleason pattern in Gleason score <= 7 tumors with pathologic stage and biochemical disease-free survival. Material and methods: A total of 331 radical prostatectomy specimens were analyzed retrospectively. The primary, secondary, and the tertiary patterns were evaluated by reviewing all of the pathologic slides. TGC was defined as Gleason grade pattern 4 or 5 for Gleason score <7 tumors and Gleason grade pattern 5 for Gleason score 7 tumors. The pathologic prognostic factors, (extraprostatic extension, seminal vesicle and lymph node invasion, surgical margin status) of Gleason score <7, 3+4, and 4+3 tumors with or without TGC were compared. Biochemical recurrence-free survival (BRFS) was calculated using Kaplan-Meier method with log rank test, and the influence of TGC was assessed in a Cox regression model. Results: TGC observed more frequently with higher Gleason scores (21% of the GS <7 cases, 23% of the GS 3+4 cases, and 58% of the GS 4+3 cases). In terms of adverse pathologic prognostic factors and BRFS, GS <7 tumors with TGC behaved significantly worse than GS <7 tumors without TGC (P = 0.01 and P = 0.001, respectively) with properties similar to GS 3+4 tumors without TGC. Gleason score 3+4 and 4+3 tumors without TGC were statistically similar and had better features than corresponding tumors of same Gleason score with TGC. Furthermore, Gleason score 7 tumors with TGC had similar features with GS 8-10 tumors. During follow-up, 73 (22%) subjects had PSA recurrence. In the Cox regression model TGC was an independent variable for BRFS (BR = 2.63, 95% CI = 1.39-4.98, P = 0.003). Conclusion: According to the present study, 3 different prognostic groups were observed; good prognostic group: GS <7, intermediate prognostic group: GS <7+TGC, GS 3+4, and GS 4+3, and finally bad prognostic group: GS (3+4)+TGC, GS (4+3)+TGC, GS >7. Presence of a TGC appears to upgrade the total score and adjuvant treatment decisions may further be refined by considering the tertiary pattern. (C) 2013 Elsevier Inc. All rights reserved.
dc.identifier.doi10.1016/j.urolonc.2010.10.009
dc.identifier.endpage98
dc.identifier.issn1078-1439
dc.identifier.issn1873-2496
dc.identifier.issue1en_US
dc.identifier.pmid21316989
dc.identifier.scopus2-s2.0-84873999381
dc.identifier.scopusqualityQ1
dc.identifier.startpage93
dc.identifier.urihttps://doi.org/10.1016/j.urolonc.2010.10.009
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8502
dc.identifier.volume31
dc.identifier.wosWOS:000315472900016
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorTürker, Polat
dc.language.isoen
dc.publisherElsevier Science Inc
dc.relation.ispartofUrologic Oncology-Seminars and Original Investigations
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectProstate cancer pathology
dc.subjectTertiary Gleason
dc.subjectSurvival
dc.subjectRadical Prostatectomy Specimens
dc.subjectPrognostic-Significance
dc.subjectProstatic Adenocarcinoma
dc.subjectMultivariate-Analysis
dc.subjectPathological Stage
dc.subjectCancer
dc.subjectProgression
dc.subjectPrediction
dc.subjectCarcinoma
dc.subjectMen
dc.titlePresence of high grade tertiary Gleason pattern upgrades the Gleason sum score and is inversely associated with biochemical recurrence-free survival
dc.typeArticle

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