Takeaway
- In patients with high-grade prostate cancer undergoing radical prostatectomy (RP), those with Gleason score (GS) 8-10 and pathologic stage T2 (pT2) show higher biochemical recurrence (BCR) and cancer-specific mortality vs those with GS 7 and pT3.
Why this matters
- In patients with high adverse features, guidelines recommend adjuvant radiotherapy without considering the GS at the time of RP.
Study design
- Study of 1585 men with prostate cancer who underwent RP divided into 3 groups:
- group 1 (GS 3+4 and pT3; n=760),
- group 2 (GS 4+3 and pT3; n=565), and
- group 3 (GS 8-10 and pT2; n=260).
- Funding: No external funding.
Key results
- Median follow-up of 58 months.
- 721 men had BCR and 84 cancer-specific deaths were reported.
- In groups 1, 2, and 3:
- 10-year BCR-free survival rates were 50.9%, 33.2%, and 28.6%, respectively.
- 15-year all-cause mortality rates were 27.2%, 25.6%, and 50.8%, respectively.
- 15-year cancer-specific mortality rates were 2.1%, 8.9%, and 42.6%, respectively.
- BCR-free survival was significantly lower in group 3 vs group 1 (P<.001 but similar vs group>
- All-cause mortality was not significantly different between groups.
- Cancer-specific survival was significantly lower in group 3 vs groups 1 (P=.001) and 2 (P=.005).
Limitations
- Retrospective design.
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