Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion‑matched biopsy specimens

  • Authors:
    • Yuki Maruyama
    • Takuya Sadahira
    • Motoo Araki
    • Yosuke Mitsui
    • Koichiro Wada
    • Acosta Gonzalez Herik Rodrigo
    • Kazuaki Munetomo
    • Yasuyuki Kobayashi
    • Masami Watanabe
    • Hiroyuki Yanai
    • Toyohiko Watanabe
    • Yasutomo Nasu
  • View Affiliations

  • Published online on: February 10, 2020     https://doi.org/10.3892/mco.2020.1996
  • Pages: 384-389
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Abstract

The present study investigated the concordance between Gleason scores assigned to prostate biopsy specimens by outside pathologists and a urological pathology expert, and determined the risk of upgrading between opinion‑matched Gleason grade group (GGG) 1 biopsy specimens and radical prostatectomy specimens. Between January 2012 and May 2018, 733 patients underwent robot‑assisted radical prostatectomy. Patients whose original biopsy specimens from outside hospitals were reviewed by a urological pathology expert Okayama University Hospital were included. Patients who had received neoadjuvant hormonal therapy were excluded. Logistic regression analysis was used to identify predictors of upgrading among GGG 1 diagnoses. A total of 403 patients were included in the present study. Agreement in GGG between initial and second‑opinion diagnoses was present in 256 cases (63.5%). Although opinion‑matched cases improved concordance between biopsy and prostatectomy specimen GGG compared with single‑opinion cases (initial, 35.2%; second‑opinion, 36.5%; matched, 41.4%), 71% (56/79) of cases classified as GGG 1 were upgraded after prostatectomy. Multivariate analysis revealed that prostate‑specific antigen density and Prostate Imaging Reporting and Data System version 2 score were significant predictors of upgrading (odds ratio, 1.10; P=0.01; and odds ratio, 1.88; P=0.03, respectively). In conclusion, the GGG concordance rate between needle‑core biopsy and radical prostatectomy specimens was higher in opinion‑matched cases; however, 71% of opinion‑matched GGG1 cases were upgraded after robot‑assisted radical prostatectomy. Urologists should propose treatment strategies or further biopsy rather than active surveillance for patients with GGG1 and a high PSAD and/or PI‑RADS score.

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April 2020
Volume 12 Issue 4

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APA
Maruyama, Y., Sadahira, T., Araki, M., Mitsui, Y., Wada, K., Rodrigo, A.G. ... Nasu, Y. (2020). Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion‑matched biopsy specimens. Molecular and Clinical Oncology, 12, 384-389. https://doi.org/10.3892/mco.2020.1996
MLA
Maruyama, Y., Sadahira, T., Araki, M., Mitsui, Y., Wada, K., Rodrigo, A. G., Munetomo, K., Kobayashi, Y., Watanabe, M., Yanai, H., Watanabe, T., Nasu, Y."Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion‑matched biopsy specimens". Molecular and Clinical Oncology 12.4 (2020): 384-389.
Chicago
Maruyama, Y., Sadahira, T., Araki, M., Mitsui, Y., Wada, K., Rodrigo, A. G., Munetomo, K., Kobayashi, Y., Watanabe, M., Yanai, H., Watanabe, T., Nasu, Y."Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion‑matched biopsy specimens". Molecular and Clinical Oncology 12, no. 4 (2020): 384-389. https://doi.org/10.3892/mco.2020.1996