Upgrading of Gleason score 6 prostate cancers on biopsy after prostatectomy in the low and intermediate tPSA range

• Verfasst von: Colleselli, Daniela [VerfasserIn]
• Verfasst von: Pelzer, Alexandre E. [VerfasserIn]
• Verfasst von: Steiner, E. [VerfasserIn]
• Verfasst von: Ongarello, S. [VerfasserIn]
• Verfasst von: Schaefer, G. [VerfasserIn]
• Verfasst von: Bartsch, G. [VerfasserIn]
• Verfasst von: Schwentner, C. [VerfasserIn]
• Titel: Upgrading of Gleason score 6 prostate cancers on biopsy after prostatectomy in the low and intermediate tPSA range
• Verf.angabe: D. Colleselli, A.E. Pelzer, E. Steiner, S. Ongarello, G. Schaefer, G. Bartsch and C. Schwentner
• Jahr: 2010
• Umfang: 4 S.
• Fussnoten: Online published: 22 December 2009 ; Gesehen am 10.05.2023
• Titel Quelle: Enthalten in: Prostate cancer and prostatic diseases
• Ort Quelle: Basingstoke : Stockton Press, 1997
• Jahr Quelle: 2010
• Band/Heft Quelle: 13(2010), 2, Seite 182-185
• ISSN Quelle: 1476-5608
• DOI: doi:10.1038/pcan.2009.54
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Adult
• Sach-SW: Aged
• Sach-SW: Biopsy
• Sach-SW: Diagnostic Errors
• Sach-SW: Humans
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Neoplasm Staging
• Sach-SW: Prostate-Specific Antigen
• Sach-SW: Prostatectomy
• Sach-SW: Prostatic Neoplasms
• K10plus-PPN: 1845045971

Abstract

When offering watchful waiting or active monitoring protocols to prostate cancer (PCa) patients, differentiation between Gleason scores (GS) 6 and 7 at biopsy is important. However, upgrading after prostatectomy is common. We investigated the impact of different PSA levels on misclassification in the PSA range of 2-3.9 and 4-10 ng ml(-1). A total of 448 patients with GS 6 PCa on prostate biopsy were evaluated by comparing biopsy and prostatectomy GS. Possible over diagnosis was defined as GS <7, pathological stage pT2a and negative surgical margins, and possible under diagnosis was defined as pT3a or greater, or positive surgical margins; the percentage of over- or under diagnosis was determined for correctly and upgraded tumors after prostatectomy. A match between biopsy and prostatectomy GS was found in 210 patients (46.9%). Patients in the PSA range of 2.0-3.9 and 4.0-10.0 ng ml(-1) were upgraded in 32.6 and 44.0%, respectively. Over diagnosis was more common than under diagnosis (23.2% vs 15.6%). When upgraded there was a significant increase in under diagnosis. As almost 40% of GS 6 tumors on biopsy are GS 7 or higher after surgery with a significant rise in under diagnosis there is a risk of misclassification and subsequent delayed or even insufficient treatment, when relying on favorable biopsy GS.