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Predictive Factors and Oncologic Outcome of Downgrade to Pathologic Gleason Score 6⁻7 after Radical Prostatectomy in Patients with Biopsy Gleason Score 8⁻10

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dc.contributor.author이종수-
dc.contributor.author장원식-
dc.contributor.author정두용-
dc.contributor.author최영득-
dc.date.accessioned2019-07-11T03:36:05Z-
dc.date.available2019-07-11T03:36:05Z-
dc.date.issued2019-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/170053-
dc.description.abstractGleason score (GS) 8⁻10 is associated with adverse outcomes in prostate cancer (PCa). However, biopsy GS (bGS) may be upgraded or downgraded post-radical prostatectomy (RP). We aimed to investigate predictive factors and oncologic outcomes of downgrade to pathologic GS (pGS) 6⁻7 after RP in PCa patients with bGSs 8⁻10. We retrospectively reviewed clinical data of patients with bGS ≥ 8 undergoing RP. pGS downgrade was defined as a pGS ≤ 7 from bGS ≥ 8 post-RP. Univariate and multivariate cox regression analysis, logistic regression analysis, and Kaplan⁻Meier curves were used to analyze pGS downgrade and biochemical recurrence (BCR). Of 860 patients, 623 and 237 had bGS 8 and bGS ≥ 9, respectively. Post-RP, 332 patients were downgraded to pGS ≤ 7; of these, 284 and 48 had bGS 8 and bGS ≥ 9, respectively. Prostate-specific antigen (PSA) levels; clinical stage; and adverse pathologic features such as extracapsular extension, seminal vesicle invasion and positive surgical margin were significantly different between patients with pGS ≤ 7 and pGS ≥ 8. Furthermore, bGS 8 (odds ratio (OR): 0.349, p < 0.001), PSA level < 10 ng/mL (OR: 0.634, p = 0.004), and ≤cT3a (OR: 0.400, p < 0.001) were identified as significant predictors of pGS downgrade. pGS downgrade was a significant positive predictor of BCR following RP in patients with high bGS (vs. pGS 8, hazard radio (HR): 1.699, p < 0.001; vs. pGS ≥ 9, HR: 1.765, p < 0.001). In addition, the 5-year BCR-free survival rate in patients with pGS downgrade significantly differed from that in patients with bGS 8 and ≥ 9 (52.9% vs. 40.7%, p < 0.001). Among patients with bGS ≥ 8, those with bGS 8, PSA level < 10 ng/mL, and ≤cT3a may achieve pGS downgrade after RP. These patients may have fewer adverse pathologic features and show a favorable prognosis; thus we suggest that active treatment is needed in these patients. In addition, patients with high-grade bGS should be managed aggressively, even if they show pGS downgrade.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherMDPI AG-
dc.relation.isPartOfJOURNAL OF CLINICAL MEDICINE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titlePredictive Factors and Oncologic Outcome of Downgrade to Pathologic Gleason Score 6⁻7 after Radical Prostatectomy in Patients with Biopsy Gleason Score 8⁻10-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Urology (비뇨의학교실)-
dc.contributor.googleauthorDoo Yong Chung-
dc.contributor.googleauthorJong Soo Lee-
dc.contributor.googleauthorHyeok Jun Goh-
dc.contributor.googleauthorDong Hoon Koh-
dc.contributor.googleauthorMin Seok Kim-
dc.contributor.googleauthorWon Sik Jang-
dc.contributor.googleauthorYoung Deuk Choi-
dc.identifier.doi10.3390/jcm8040438-
dc.contributor.localIdA05500-
dc.contributor.localIdA05268-
dc.contributor.localIdA05268-
dc.contributor.localIdA04664-
dc.contributor.localIdA04664-
dc.contributor.localIdA04111-
dc.contributor.localIdA04111-
dc.relation.journalcodeJ03556-
dc.identifier.eissn2077-0383-
dc.identifier.pmid30935044-
dc.subject.keywordgleason score-
dc.subject.keywordmagnetic resonance imaging-
dc.subject.keywordprostatic neopla는-
dc.contributor.alternativeNameLee, Jong Soo-
dc.contributor.affiliatedAuthor이종수-
dc.contributor.affiliatedAuthor장원식-
dc.contributor.affiliatedAuthor장원식-
dc.contributor.affiliatedAuthor정두용-
dc.contributor.affiliatedAuthor정두용-
dc.contributor.affiliatedAuthor최영득-
dc.contributor.affiliatedAuthor최영득-
dc.citation.volume8-
dc.citation.number4-
dc.citation.startPageE438-
dc.identifier.bibliographicCitationJOURNAL OF CLINICAL MEDICINE, Vol.8(4) : E438, 2019-
dc.identifier.rimsid62261-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers

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