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Chulalongkorn Medical Journal

Abstract

Background: Gleason score is an important pathologic factor for risk stratification in prostate cancer. Upgraded Gleason score is not uncommon after radical prostatectomyObjectives: This study aimed to investigate the prevalence of upgraded Gleason scores between trans rectalultrasound guided prostate biopsy (TRUS-biopsy) and radical prostatectomy (RP) specimen and to determinethe predictive factors for increased Gleason scores.Methods: We retrospectively reviewed the medical records of prostate cancer patients who underwent RP from June 2006 – June 2016 at King Chulalongkorn Memorial Hospital (KCMH). Gleason scores from TRUS-biopsy and RP were compared. Pre-operative clinical parameters were analyzed to determine the risk factors of upgraded Gleason scores between the group of patients with increased Gleason scores and those with no increased Gleason scores.Results: In all, 33% (68/204) of patients had upgraded Gleason scores after RP. Patients with upgraded Gleason scores had significantly lower ages (P = 0.02), higher PSA levels (P = 0.01) and longer durations from TRUS-biopsy to RP (P = 0.047). Patient’s age gif.latex?\leq 65 years, PSA gif.latex?\geq10 ng/mL and duration from TRUS-biopsy to RP gif.latex?\geq 6 months were statistically significant factors for increased Gleason scores in both univariate and multivariate analysis.Conclusions: The prevalence of upgraded Gleason scores is 33%. Patient’s age gif.latex?\leq 65 years, PSA gif.latex?\geq 10 ng/ml andduration from TRUS-biopsy to RP gif.latex?\geq 6 months are predictors for upgrading Gleason score after surgery. Theseresults provide clinical implication for the treatment planning of patients with risk of upgraded prostate cancer.

DOI

10.58837/CHULA.CMJ.63.3.1

First Page

137

Last Page

142

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