Tertiary Gleason pattern 5 and oncological outcomes after radical prostatectomy.
Tertiary Gleason pattern 5 and oncological outcomes after radical prostatectomy.
复制标题
三级格里森模式 5 和根治性前列腺切除术后的肿瘤学结果。
DOI：
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发表时间：
2011
影响因子：
2.4
通讯作者：
N. Teramoto
中科院分区：
文献类型：
--
作者：
K. Hashine;Akihito Yuasa;Kensuke Shinomori;A. Shirato;I. Ninomiya;N. Teramoto
目标
本研究检查了Gleason 5型的发生率以及三级Gleason 5型对肿瘤结局的影响。
方法
1993年至2008年间，466例患者接受了根治性直肠癌切除术。对每例手术标本进行了肿瘤直径、Gleason评分（基于2005年国际泌尿病理学会共识会议标准）和Gleason 5型百分比的审查和评估。
结果
患者的中位年龄为68.0岁，中位前列腺特异性抗原水平为9.28 ng/ml。Gleason评分<9的患者中有24.2%存在三级Gleason模式5; Gleason评分3 + 4的患者中有12.2%存在三级Gleason模式5; Gleason评分4 + 3的患者中有45.9%存在三级Gleason模式5。一项多变量分析显示，在Gleason评分为7和8 pN 0组的患者中，三级Gleason模式5与生化无复发生存率无关。187例患者有任何比率的格里森模式5和显着恶化的病理因素，与患者相比，谁没有这种模式。对所有患者进行多因素分析，结果显示手术切缘、Gleason评分、前列腺特异性抗原水平和病理分期均为生化复发的独立预测因素。但Gleason 5型发生率不是独立因素。
结论
三级Gleason模式5不是生化复发的显著预测因子。Gleason 5型发生率与不良病理因素有关。
OBJECTIVES
This study examined the rate of Gleason pattern 5 and the influence of tertiary Gleason pattern 5 on oncological outcomes.
METHODS
Four hundred sixty-six patients underwent a radical prostatectomy between 1993 and 2008. Each surgical specimen was reviewed and assessed for the tumor diameter, Gleason score (which was based on the 2005 International Society of Urological Pathology Consensus Conference criteria) and the percentage of Gleason pattern 5.
RESULTS
The median patient age was 68.0 years old and the median prostate-specific antigen level was 9.28 ng/ml. A tertiary Gleason pattern 5 was present in 24.2% of patients with a Gleason score of <9; in 12.2% of patients with a Gleason score of 3 + 4 and in 45.9% of patients with a Gleason score of 4 + 3. A multivariate analysis showed that a tertiary Gleason pattern 5 was not independently associated with biochemical recurrence-free survival among patients in the Gleason score of 7 and 8 pN0 groups. One hundred eighty-seven patients had any rate of Gleason pattern 5 and significantly worse pathological factors, compared with patients who did not have this pattern. A multivariate analysis of all patients showed that the surgical margin, Gleason score, prostate-specific antigen level and pathological stage were all independent predictors of biochemical recurrence. However, the rate of Gleason pattern 5 was not an independent factor.
CONCLUSIONS
Tertiary Gleason pattern 5 was not a significant predictive factor for biochemical recurrence. The rate of Gleason pattern 5 was associated with adverse pathological factors.
DOI：
10.1016/s0022-5347(05)00388-5
发表时间：
2005-07
期刊：
JAMA
影响因子：
--
作者：
S. Freedland;E. Humphreys;L. Mangold;M. Eisenberger;F. Dorey;P. Walsh;A. Partin
通讯作者：
S. Freedland;E. Humphreys;L. Mangold;M. Eisenberger;F. Dorey;P. Walsh;A. Partin
影响因子：
6.6
作者：
Freedland, Stephen J.;Humphreys, Elizabeth B.;Partin, Alan W.
通讯作者：
Partin, Alan W.