Prognostic significance of the presence of tertiary Gleason grade 5 in robot-assisted radical prostatectomy specimens in Japanese patients with clinically localized prostate cancer
Prognostic significance of the presence of tertiary Gleason grade 5 in robot-assisted radical prostatectomy specimens in Japanese patients with clinically localized prostate cancer
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日本临床局限性前列腺癌患者机器人辅助根治性前列腺切除术标本中存在三级格里森 5 级的预后意义
DOI：
10.1093/jjco/hyy194
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发表时间：
2019
影响因子：
2.4
通讯作者：
Ohno Yoshio
中科院分区：
文献类型：
--
作者：
Kamoda Naohiro;Ohori Makoto;Hirasawa Yosuke;Inoue Rie;Hashimoto Takeshi;Satake Naoya;Gondo Tatsuo;Nakagami Yoshihiro;Nagao Toshitaka;Ohno Yoshio
BackgroundThe本研究的目的是研究第三级Gleason分级（TGG）5的预后意义与机器人辅助根治性前列腺切除术（RARP）治疗的临床局限性前列腺癌患者。方法共600例日本患者进行RARP临床分期T1- 3 N 0 M0前列腺癌进行了评估。根据国际泌尿病理学会标准对TGG 5进行评价。考克斯风险回归被用来评估前列腺特异性抗原和病理特征在RARP specimens.ResultsOf 600 RARP标本的预后意义，92（15%）有TGG 5。Gleason评分（GS）3 + 4的287例中30例（10%）、GS 4 + 3的149例中55例（37%）、GS 4 + 4的40例中7例（17%）存在TGG 5成分。GS 3 + 4组与GS4 + 4组、GS 3 + 4组与GS4 + 4组在病理分期、切缘情况等方面差异无统计学意义。在600例患者中，92例（15%）患者术后生化复发（BCR），中位随访期为42（3-104）个月。GS 3 + 4伴和不伴TGG 5患者的5年无BCR生存率无差异（92 vs. 100%，P = 0.16），GS4 + 3伴和不伴TGG 5患者的5年无BCR生存率无差异（79 vs. 71%，P = 0.30）。同样，GS 4 + 4伴和不伴TGG 5的患者3年BCRFS率无差异（80%对71%，P = 0.38）。结论在我们的人群中，RARP标本中TGG 5的存在对病理和预后结果无明显影响。
BackgroundThe aim of this study was to study the prognostic significance of tertiary Gleason grade (TGG) 5 in patients with clinically localized prostate cancer treated with robot-assisted radical prostatectomy (RARP).MethodsA total of 600 Japanese patients who underwent RARP for clinical stage T1-3N0M0 prostate cancer were evaluated. TGG5 was evaluated according to the International Society of Urological Pathology criterion. Cox hazard regression was used to evaluate the prognostic significance of prostate-specific antigen and pathological features in RARP specimens.ResultsOf the 600 RARP specimens, 92 (15%) had TGG5. TGG5 component was found in 30 (10%) of 287 cases with Gleason score (GS) 3 + 4, 55 (37%) of 149 cases with GS 4 + 3 and 7 (17%) of 40 cases with GS 4 + 4. There were no significant differences in pathological stage and surgical margin status between GS 3 + 4 with and without TGG5, as well as between GS 4 + 4 with and without TGG5. Of the 600 patients, 92 (15%) patients had biochemical recurrence (BCR) after surgery, with a median follow-up period of 42 (3–104) months. There were no differences in 5-year BCR-free survival rates between patients with GS 3 + 4 with and without TGG5 (92 vs. 100%,P= 0.16), as well as between patients with GS 4 + 3 with and without TGG5 (79 vs. 71%,P= 0.30). Similarly, there were no differences in 3-year BCRFS rates between patients with GS 4 + 4 with and without TGG5 (80 vs. 71%,P= 0.38).ConclusionsIn our population, the presence of TGG5 in RARP specimens had no strong impact on pathological and prognostic outcomes.
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