Initial prostate biopsy of grade group one: A study of pathological upgrade and biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy
Journal
Urological Science
Journal Volume
31
Journal Issue
4
Pages
170-176
Date Issued
2020
Author(s)
Abstract
Purpose: The aim of our study was to analyze the outcomes and predictive factors in patients with an initial biopsy grade group 1 (GG1) prostate cancer (PCa) at risk of GG upgrading. Materials and Methods: We performed a retrospective review of patients who had GG1 PCa at biopsy and were managed with robotic-assisted laparoscopic radical prostatectomy (RaLRP) from January 2012 to December 2018 and collected their clinical characteristics and pathological data. The primary outcomes were GG upgrading at RaLRP and biochemical recurrence-free survival (BCRFS) in these patients. The secondary outcome was to analyze the risk factors of pathological upgrades. Results: Among the 159 patients with initial prostate biopsy of GG1, 122 patients (76.7%) had GG upgrading based on the final pathology at RaLRP. Multivariable analysis showed that transrectal ultrasound (TRUS)-measured prostate volume <30 mL (odds ratio [OR] 4.727, P = 0.011), prostate-specific antigen density [PSAD] ?0.2 ng/mL2(OR 3.201, P = 0.019), magnetic resonance imaging (MRI)-measured prostate volume <30 mL (OR 3.892, P = 0.007), and PSAD ? 0.2 ng/mL2(OR 2.65, P = 0.019) were independent predictive factors of GG upgrading. During 5 years of follow-up, patients who upgraded to GG3-5 had a significantly shorter time to biochemical recurrence than those who remained as GG1 (P = 0.001) or upgraded to GG2 (P = 0.008). Conclusion: The final pathology grading was underestimated in 76.7% of initial biopsy GG1 and may influence the BCRFS after RaLRP. Prostate volume <30 mL and PSAD ?0.2 ng/mL2, measured by either MRI or TRUS, were significant predictive factors of biopsy GG1 upgrading. ? 2020 Wolters Kluwer Medknow Publications. All rights reserved.
SDGs
Other Subjects
prostate specific antigen; adult; aged; Article; biochemical recurrence free survival; cancer grading; clinical feature; follow up; human; human tissue; major clinical study; male; multivariate analysis; nuclear magnetic resonance imaging; predictive value; priority journal; prostate biopsy; prostate cancer; prostate volume; retrospective study; risk factor; robot-assisted prostatectomy; transrectal ultrasonography; treatment outcome
Publisher
Wolters Kluwer Medknow Publications
Type
journal article