Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer
Background: Up- and/or downgrading rates in single intermediate-risk positive biopsy core are unknown. Methods: We identified single intermediate-risk (Gleason grade group (GGG) 2/GGG3) positive biopsy core prostate cancer patients (≤ cT2c and PSA ≤ 20 ng/mL) within the Surveillance, Epidemiology, a...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-03-01
|
| Series: | Prostate International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2287888222000046 |
| _version_ | 1827838391918526464 |
|---|---|
| author | Benedikt Hoeh Rocco Flammia Lukas Hohenhorst Gabriele Sorce Francesco Chierigo Zhe Tian Fred Saad Michele Gallucci Alberto Briganti Carlo Terrone Shahrokh F. Shariat Markus Graefen Derya Tilki Luis A. Kluth Philipp Mandel Felix K.H. Chun Pierre I. Karakiewicz |
| author_facet | Benedikt Hoeh Rocco Flammia Lukas Hohenhorst Gabriele Sorce Francesco Chierigo Zhe Tian Fred Saad Michele Gallucci Alberto Briganti Carlo Terrone Shahrokh F. Shariat Markus Graefen Derya Tilki Luis A. Kluth Philipp Mandel Felix K.H. Chun Pierre I. Karakiewicz |
| author_sort | Benedikt Hoeh |
| collection | DOAJ |
| description | Background: Up- and/or downgrading rates in single intermediate-risk positive biopsy core are unknown. Methods: We identified single intermediate-risk (Gleason grade group (GGG) 2/GGG3) positive biopsy core prostate cancer patients (≤ cT2c and PSA ≤ 20 ng/mL) within the Surveillance, Epidemiology, and End Results (SEER) database (2010–2015). Subsequently, separate uni- and multivariable logistic regression models tested for independent predictors of up- and downgrading. Results: Of 1,328 assessable patients with single core positive intermediate-risk prostate cancer at biopsy, 972 (73%) harbored GGG2 versus 356 (27%) harbored GGG3. Median PSA (5.5 vs 5.7; p = 0.3), median age (62 vs 63 years; p = 0.07) and cT1-stage (77 vs 75%; p = 0.3) did not differ between GGG2 and GGG3 patients. Of individuals with single GGG2 positive biopsy core, 191 (20%) showed downgrading to GGG1 versus 35 (4%) upgrading to GGG4 or GGG5 at RP. Of individuals with single GGG3 positive biopsy core, 36 (10%) showed downgrading to GGG1 versus 42 (12%) significant upgrading to GGG4 or GGG5 at RP. In multivariable logistic regression models, elevated PSA (10–20 ng/mL) was an independent predictor of upgrading to GGG4/GGG5 in single GGG3 positive biopsy core patients (OR:2.89; 95%-CI: 1.31–6.11; p = 0.007). Conclusion: In single GGG2 positive biopsy core patients, downgrading was four times more often recorded compared to upgrading. Conversely, in single GGG3 positive biopsy core patients, up- and downgrading rates were comparable and should be expected in one out of ten patients. |
| first_indexed | 2024-03-12T07:05:15Z |
| format | Article |
| id | doaj.art-7f017d5f0e3a4b62a1a5363036dc60c4 |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T07:05:15Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-7f017d5f0e3a4b62a1a5363036dc60c42023-09-02T23:31:05ZengElsevierProstate International2287-88822022-03-011012127Up- and downgrading in single intermediate-risk positive biopsy core prostate cancerBenedikt Hoeh0Rocco Flammia1Lukas Hohenhorst2Gabriele Sorce3Francesco Chierigo4Zhe Tian5Fred Saad6Michele Gallucci7Alberto Briganti8Carlo Terrone9Shahrokh F. Shariat10Markus Graefen11Derya Tilki12Luis A. Kluth13Philipp Mandel14Felix K.H. Chun15Pierre I. Karakiewicz16Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt Am Main, Frankfurt Am Main, Germany; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Corresponding author. Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, ItalyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, GermanyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, ItalyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, ItalyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaDepartment of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, ItalyDivision of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, ItalyDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, JordanMartini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, GermanyMartini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, TurkeyDepartment of Urology, University Hospital Frankfurt, Goethe University Frankfurt Am Main, Frankfurt Am Main, GermanyDepartment of Urology, University Hospital Frankfurt, Goethe University Frankfurt Am Main, Frankfurt Am Main, GermanyDepartment of Urology, University Hospital Frankfurt, Goethe University Frankfurt Am Main, Frankfurt Am Main, GermanyCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, CanadaBackground: Up- and/or downgrading rates in single intermediate-risk positive biopsy core are unknown. Methods: We identified single intermediate-risk (Gleason grade group (GGG) 2/GGG3) positive biopsy core prostate cancer patients (≤ cT2c and PSA ≤ 20 ng/mL) within the Surveillance, Epidemiology, and End Results (SEER) database (2010–2015). Subsequently, separate uni- and multivariable logistic regression models tested for independent predictors of up- and downgrading. Results: Of 1,328 assessable patients with single core positive intermediate-risk prostate cancer at biopsy, 972 (73%) harbored GGG2 versus 356 (27%) harbored GGG3. Median PSA (5.5 vs 5.7; p = 0.3), median age (62 vs 63 years; p = 0.07) and cT1-stage (77 vs 75%; p = 0.3) did not differ between GGG2 and GGG3 patients. Of individuals with single GGG2 positive biopsy core, 191 (20%) showed downgrading to GGG1 versus 35 (4%) upgrading to GGG4 or GGG5 at RP. Of individuals with single GGG3 positive biopsy core, 36 (10%) showed downgrading to GGG1 versus 42 (12%) significant upgrading to GGG4 or GGG5 at RP. In multivariable logistic regression models, elevated PSA (10–20 ng/mL) was an independent predictor of upgrading to GGG4/GGG5 in single GGG3 positive biopsy core patients (OR:2.89; 95%-CI: 1.31–6.11; p = 0.007). Conclusion: In single GGG2 positive biopsy core patients, downgrading was four times more often recorded compared to upgrading. Conversely, in single GGG3 positive biopsy core patients, up- and downgrading rates were comparable and should be expected in one out of ten patients.http://www.sciencedirect.com/science/article/pii/S2287888222000046DowngradingIntermediate-riskProstate cancerSingle positive core biopsyUpgrading |
| spellingShingle | Benedikt Hoeh Rocco Flammia Lukas Hohenhorst Gabriele Sorce Francesco Chierigo Zhe Tian Fred Saad Michele Gallucci Alberto Briganti Carlo Terrone Shahrokh F. Shariat Markus Graefen Derya Tilki Luis A. Kluth Philipp Mandel Felix K.H. Chun Pierre I. Karakiewicz Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer Prostate International Downgrading Intermediate-risk Prostate cancer Single positive core biopsy Upgrading |
| title | Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer |
| title_full | Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer |
| title_fullStr | Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer |
| title_full_unstemmed | Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer |
| title_short | Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer |
| title_sort | up and downgrading in single intermediate risk positive biopsy core prostate cancer |
| topic | Downgrading Intermediate-risk Prostate cancer Single positive core biopsy Upgrading |
| url | http://www.sciencedirect.com/science/article/pii/S2287888222000046 |
| work_keys_str_mv | AT benedikthoeh upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT roccoflammia upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT lukashohenhorst upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT gabrielesorce upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT francescochierigo upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT zhetian upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT fredsaad upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT michelegallucci upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT albertobriganti upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT carloterrone upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT shahrokhfshariat upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT markusgraefen upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT deryatilki upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT luisakluth upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT philippmandel upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT felixkhchun upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer AT pierreikarakiewicz upanddowngradinginsingleintermediateriskpositivebiopsycoreprostatecancer |