J Korean Med Sci.  2011 Apr;26(4):507-512. 10.3346/jkms.2011.26.4.507.

Clinical Significance of a Large Difference (> or = 2 points) between Biopsy and Post-prostatectomy Pathological Gleason Scores in Patients with Prostate Cancer

Affiliations
  • 1Department of Urology, College of Medicine, Hallym University, Chuncheon, Korea.
  • 2Department of Urology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
  • 3Department of Urology, Sungkyunkwan University, School of Medicine, Seoul, Korea. hanyong.choi@samsung.com
  • 4Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic university of Korea, Seoul, Korea.
  • 5Department of Urology, College of Medicine, Korea University, Seoul, Korea.
  • 6Urologic Oncology Clinic, National Cancer Center, Goyang, Korea.
  • 7Department of Urology, College of Medicine, Kyungpook National University, Daegu, Korea.
  • 8Department of Urology, Seoul Veterans Hospital, Seoul, Korea.
  • 9Department of Urology, College of Medicine, Pusan National University, Busan, Korea.
  • 10Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 11Department of Urology, Seoul National University, College of Medicine, Seoul, Korea.
  • 12Department of Urology, Urological Science Institute, Yonsei University, College of Medicine, Seoul, Korea.
  • 13Department of Urology, Chonbuk National University Medical School, Jeonju, Korea.
  • 14Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea.

Abstract

We investigated the clinical significance of large difference (> or = 2 points) between biopsy-derived (bGS) and post-prostatectomy Gleason scores (pGS). At 14 medical centers in Korea, 1,582 men who underwent radical prostatectomy for prostate cancer were included. According to the difference between bGS and pGS, the patients were divided into three groups: A (decreased in pGS > or = 2, n = 30), B (changed in pGS < or = 1, n = 1,361; control group), and C (increased in pGS > or = 2, n = 55). We evaluated various clinicopathological factors of prostate cancer and hazards for biochemical failure. Group A showed significantly higher mean maximal percentage of cancer in the positive cores (max%) and pathological T stage than control. In group C, the number of biopsy core was significantly smaller, however, tumor volume and max% were significantly higher and more positive biopsy cores were presented than control. Worse pathological stage and more margin-positive were observed in group A and C than in control. Hazard ratio for biochemical failure was also higher in group A and C (P = 0.001). However, the groups were not independent factors in multivariate analysis. In conclusion, large difference between bGS and pGS shows poor prognosis even in the decreased group. However it is not an independent prognostic factor for biochemical failure.

Keyword

Prostatic Neoplasms; Gleason Score; Prognosis
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