Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 years
Objective: To assess the management and oncological outcomes in men diagnosed with Gleason score (GS) 6 prostate cancer on needle biopsy in a regional centre, as compared with published international data. Materials and methods: A retrospective analysis was conducted of patients who were diagnosed w...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-12-01
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| Series: | Prostate International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S228788821730020X |
| _version_ | 1797766313144221696 |
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| author | Brayden March George Koufogiannis Mark Louie-Johnsun |
| author_facet | Brayden March George Koufogiannis Mark Louie-Johnsun |
| author_sort | Brayden March |
| collection | DOAJ |
| description | Objective: To assess the management and oncological outcomes in men diagnosed with Gleason score (GS) 6 prostate cancer on needle biopsy in a regional centre, as compared with published international data.
Materials and methods: A retrospective analysis was conducted of patients who were diagnosed with GS 6 prostate cancer via transrectal ultrasound-guided or transperineal biopsy between June 2009 and September 2015 under the care of a single surgeon. Data were obtained from a prospectively collected database.
Results: A total of 166 patients were diagnosed with GS 6 prostate cancer. The mean age was 61 (range 46–79) years, with mean prostate-specific antigen of 6.7 (0.91–26.8) ng/mL at diagnosis. Of 166 patients, 117 (70.5%) patients were enrolled into the active surveillance program with 82 (70%) meeting Prostate Cancer Research International Active Surveillance (PRIAS) criteria, 44 patients underwent immediate definitive treatment (88.6% radical prostatectomy and 9.1% radiotherapy) and five watchful waiting. With a median follow-up of 1.8 years, 37 (31.6%) patients on AS had definitive treatment [30 cases (81%) were attributable to disease progression, 4 cases (10.8%) to an abnormal magnetic resonance imaging result and 3 cases (8.1%) for patient preference]. In the 35 patients who underwent radical prostatectomy immediately after diagnosis, the GS was ≥7 in 29 cases (82.9%), and the final pathology was pT3a in 16 (51.6%) and pT3b in one (2.9%). In patients who underwent radical prostatectomy after being on AS, the proportion of GS ≥7 prostate cancer was 29/32 (90.6%), with pT3a in six (18.8%) and pT3b in three (9.4%) cases. Overall, 23.5% of patients had a multiparametric magnetic resonance imaging scan.
Conclusion: This single-surgeon cohort of GS 6 prostate cancer patients demonstrates a high proportion of cases managed with active surveillance, with comparable rates to international literature. The majority of cases who underwent immediate definitive treatment had significant disease, indicating that patients are being appropriately selected for active surveillance. |
| first_indexed | 2024-03-12T20:22:29Z |
| format | Article |
| id | doaj.art-71311a3d28d5450d917f550b0e0d701d |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T20:22:29Z |
| publishDate | 2017-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-71311a3d28d5450d917f550b0e0d701d2023-08-02T00:47:29ZengElsevierProstate International2287-88822017-12-015413914210.1016/j.prnil.2017.03.007Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 yearsBrayden March0George Koufogiannis1Mark Louie-Johnsun2Gosford Hospital, Gosford, NSW, AustraliaGosford Hospital, Gosford, NSW, AustraliaGosford Hospital, Gosford, NSW, AustraliaObjective: To assess the management and oncological outcomes in men diagnosed with Gleason score (GS) 6 prostate cancer on needle biopsy in a regional centre, as compared with published international data. Materials and methods: A retrospective analysis was conducted of patients who were diagnosed with GS 6 prostate cancer via transrectal ultrasound-guided or transperineal biopsy between June 2009 and September 2015 under the care of a single surgeon. Data were obtained from a prospectively collected database. Results: A total of 166 patients were diagnosed with GS 6 prostate cancer. The mean age was 61 (range 46–79) years, with mean prostate-specific antigen of 6.7 (0.91–26.8) ng/mL at diagnosis. Of 166 patients, 117 (70.5%) patients were enrolled into the active surveillance program with 82 (70%) meeting Prostate Cancer Research International Active Surveillance (PRIAS) criteria, 44 patients underwent immediate definitive treatment (88.6% radical prostatectomy and 9.1% radiotherapy) and five watchful waiting. With a median follow-up of 1.8 years, 37 (31.6%) patients on AS had definitive treatment [30 cases (81%) were attributable to disease progression, 4 cases (10.8%) to an abnormal magnetic resonance imaging result and 3 cases (8.1%) for patient preference]. In the 35 patients who underwent radical prostatectomy immediately after diagnosis, the GS was ≥7 in 29 cases (82.9%), and the final pathology was pT3a in 16 (51.6%) and pT3b in one (2.9%). In patients who underwent radical prostatectomy after being on AS, the proportion of GS ≥7 prostate cancer was 29/32 (90.6%), with pT3a in six (18.8%) and pT3b in three (9.4%) cases. Overall, 23.5% of patients had a multiparametric magnetic resonance imaging scan. Conclusion: This single-surgeon cohort of GS 6 prostate cancer patients demonstrates a high proportion of cases managed with active surveillance, with comparable rates to international literature. The majority of cases who underwent immediate definitive treatment had significant disease, indicating that patients are being appropriately selected for active surveillance.http://www.sciencedirect.com/science/article/pii/S228788821730020XProstate cancerGleason 6Active surveillance |
| spellingShingle | Brayden March George Koufogiannis Mark Louie-Johnsun Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 years Prostate International Prostate cancer Gleason 6 Active surveillance |
| title | Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 years |
| title_full | Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 years |
| title_fullStr | Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 years |
| title_full_unstemmed | Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 years |
| title_short | Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 years |
| title_sort | management and outcomes of gleason six prostate cancer detected on needle biopsy a single surgeon experience over 6 years |
| topic | Prostate cancer Gleason 6 Active surveillance |
| url | http://www.sciencedirect.com/science/article/pii/S228788821730020X |
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