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Upgrading of Gleason score and prostate volume: a clinicopathological analysis

 Kwang Hyun Kim  ;  Sey Kiat Lim  ;  Tae-Young Shin  ;  Joo Yong Lee  ;  Byung Ha Chung  ;  Koon Ho Rha  ;  Sung Joon Hong 
 BJU INTERNATIONAL, Vol.111(8) : 1310-1316, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; Disease Progression ; Humans ; Male ; Middle Aged ; Neoplasm Grading/methods ; Neoplasm Grading/trends* ; Prostate/pathology* ; Prostatectomy ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery ; Retrospective Studies ; Tumor Burden*
prostatic neoplasm ; neoplasm grading ; tumour burden ; prostatectomy
OBJECTIVE: To more clearly elucidate the association between prostate volume and Gleason score (GS) upgrading. PATIENT AND METHODS: We reviewed 451 patients with prostate cancer with a GS of 6 on biopsy, who underwent radical prostatectomy without neoadjuvant treatment. As a preoperative variable, we assessed the independent effect of prostate volume on GS upgrading. To evaluate the association between prostate volume and GS upgrading, we developed multivariate models with volumetric pathological variables, including postoperative tumour volume and percent tumour volume (tumour volume as a percentage of prostate volume). RESULTS: GS upgrading was observed in 194 patients (43.0%). As a preoperative variable, smaller prostate volume was an independent predictor of GS upgrading. In regression analysis, prostate volume and postoperative tumour volume were inversely correlated. On multivariate analysis including volumetric pathological variables, tumour volume was a strong independent factor influencing GS upgrading, and prostate volume lost statistical significance after adjusting for tumour volume. Percent tumour volume was inversely correlated with GS upgrading after adjusting for tumour volume. CONCLUSIONS: Smaller prostate volume was an independent predictor of GS upgrading as a preoperative variable. The inverse relationship between prostate volume and GS upgrading seems to be attributable to cancer biology, which was represented by tumour volume in our study. Percent tumour volume was also inversely associated with GS upgrading. These results suggest that biological factors and sampling error both play important roles in GS upgrading.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kwang Hyun(김광현)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Shin, Tae Young(신태영)
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Lim, Sey Kiat(임세이캣)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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