Cited 10 times in
The Impact of Downgrading from Biopsy Gleason 7 to Prostatectomy Gleason 6 on Biochemical Recurrence and Prostate Cancer Specific Mortality
DC Field | Value | Language |
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dc.contributor.author | 함원식 | - |
dc.date.accessioned | 2017-11-02T08:36:40Z | - |
dc.date.available | 2017-11-02T08:36:40Z | - |
dc.date.issued | 2017 | - |
dc.identifier.issn | 0022-5347 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/154672 | - |
dc.description.abstract | PURPOSE: Gleason score is one of the most important prognostic indicators for prostate cancer. Downgrading from biopsy Gleason score 7 to radical prostatectomy Gleason score 6 occurs commonly and yet to our knowledge the impact on survival outcomes is unknown. We examined biochemical recurrence and prostate cancer specific mortality risk in a large cohort evaluated by a single group of expert urological pathologists. MATERIALS AND METHODS: Of 23,918 men who underwent radical prostatectomy at our institution between 1984 and 2014, 10,236 with biopsy and radical prostatectomy Gleason score 6 or 7 without upgrading were included in analysis. The cohort was divided into 3 groups, including group 1-biopsy and radical prostatectomy Gleason score 6 in 6,923 patients (67.6%), group 2-Gleason score 7 downgraded to radical prostatectomy Gleason score 6 in 648 (6.3%) and group 3-biopsy and radical prostatectomy Gleason score 7 in 2,665 (26.0%). Biochemical recurrence and prostate cancer specific mortality risks were compared using Cox regression and competing risk analyses adjusting for clinicopathological variables. RESULTS: At a median followup of 5 years (range 1 to 29), 992 men experienced biochemical recurrence and 95 had died of prostate cancer. Biochemical recurrence-free survival in downgraded cases (group 2) was better than in group 3 cases, which had Gleason score 7 on biopsy and radical prostatectomy (p <0.001), but worse than group 1 cases, which had Gleason score 6 on biopsy and radical prostatectomy (p <0.001). Downgrading was independently associated with biochemical recurrence (adjusted HR 1.87, p <0.0001) but not with prostate cancer specific mortality (adjusted HR 1.65, p = 0.636). CONCLUSIONS: Downgrading from biopsy Gleason score 7 to radical prostatectomy Gleason score 6 was an independent predictor of biochemical recurrence but not prostate cancer specific mortality, likely due to the presence of minor amounts of Gleason pattern 4. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Elsevier | - |
dc.relation.isPartOf | JOURNAL OF UROLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.title | The Impact of Downgrading from Biopsy Gleason 7 to Prostatectomy Gleason 6 on Biochemical Recurrence and Prostate Cancer Specific Mortality | - |
dc.type | Article | - |
dc.publisher.location | United States | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Urology | - |
dc.contributor.googleauthor | Won Sik Ham | - |
dc.contributor.googleauthor | Heather J. Chalfin | - |
dc.contributor.googleauthor | Zhaoyong Feng | - |
dc.contributor.googleauthor | Bruce J. Trock | - |
dc.contributor.googleauthor | Jonathan I. Epstein | - |
dc.contributor.googleauthor | Carling Cheung | - |
dc.contributor.googleauthor | Elizabeth Humphreys | - |
dc.contributor.googleauthor | Alan W. Partin | - |
dc.contributor.googleauthor | Misop Han | - |
dc.identifier.doi | 10.1016/j.juro.2016.11.079 | - |
dc.contributor.localId | A04337 | - |
dc.relation.journalcode | J01921 | - |
dc.identifier.eissn | 1527-3792 | - |
dc.identifier.pmid | 27847296 | - |
dc.identifier.url | http://www.sciencedirect.com/science/article/pii/S0022534716317797 | - |
dc.subject.keyword | biopsy | - |
dc.subject.keyword | mortality | - |
dc.subject.keyword | neoplasm grading | - |
dc.subject.keyword | prostatectomy | - |
dc.subject.keyword | prostatic neoplasms | - |
dc.contributor.alternativeName | Ham, Won Sik | - |
dc.contributor.affiliatedAuthor | Ham, Won Sik | - |
dc.citation.title | Journal of Urology | - |
dc.citation.volume | 197 | - |
dc.citation.number | 4 | - |
dc.citation.startPage | 1060 | - |
dc.citation.endPage | 1067 | - |
dc.identifier.bibliographicCitation | JOURNAL OF UROLOGY, Vol.197(4) : 1060-1067, 2017 | - |
dc.date.modified | 2017-11-01 | - |
dc.identifier.rimsid | 43733 | - |
dc.type.rims | ART | - |
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