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Journal of Cancer Research and Clinical Oncology

, Volume 143, Issue 11, pp 2393–2400 | Cite as

Impact of Gleason score on biochemical recurrence in patients with pT3aN0/Nx prostate cancer with positive surgical margins: a multicenter study from the Prostate Cancer Research Committee

  • Wan Song
  • Dong Hyeon Lee
  • Hwang Gyun Jeon
  • Byong Chang Jeong
  • Seong Il Seo
  • Hyun Moo Lee
  • Han Yong Choi
  • Jong Wook Kim
  • SangChul Lee
  • Seok-Soo Byun
  • Chang Wook Jeong
  • Cheol Kwak
  • Jin Seon Cho
  • Hanjong AhnEmail author
  • Seong Soo JeonEmail author
Original Article – Clinical Oncology

Abstract

Purpose

Oncologic outcomes of patients with pT3aN0/Nx prostate cancer (PCa) with positive surgical margins (PSM) after radical prostatectomy (RP) are heterogeneous. We investigated the impact of Gleason score (GS) on biochemical recurrence (BCR) in these patients.

Methods

A retrospective, multicenter study was performed on 795 patients with pT3aN0/Nx PCa with PSM after RP between January 2006 and December 2014. Clinicopathologic characteristics of patients were examined and onset of BCR was identified. Kaplan–Meier survival analysis was used to illustrate BCR-free survival (BFS) and Cox proportional hazard models were applied to identify factors predicting BCR.

Results

During the mean follow-up period of 63.9 months, BCR was identified in 274 (34.5%) patients. The 5-year BFS was 56.6% in all patients. In multivariate analysis, pathologic GS was the only significant prognostic factor for BCR in patients with pT3aN0/Nx PCa with PSM (GS 6 vs. GS 7 (3 + 4), P = 0.047; vs. GS 7 (4 + 3), P = 0.007, and vs. GS 8–10, P < 0.001). When patients were stratified according to GS, 5-year BFS was 78.6% in GS 6, 66.2% in GS 7 (3 + 4), 51.1% in GS 7 (4 + 3) and 35.5% in GS 8–10.

Conclusions

In patients with pT3aN0/Nx with PSM after RP, pathologic GS is the sole independent predictor for risk stratification of BCR. These findings might be used to determine the risk and timing of BCR and to help counsel patients regarding treatment strategy and prognosis of disease on an individual basis.

Keywords

Biochemical recurrence Gleason score Positive surgical margin Prostate cancer Prognostic factor 

Notes

Acknowledgements

This study was performed by the Prostate Cancer Research Committee of the Korean Urological Oncology Society.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

No funding was received.

Informed consent

Written informed consent was exempted because of the retrospective study design.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Wan Song
    • 1
  • Dong Hyeon Lee
    • 1
  • Hwang Gyun Jeon
    • 2
  • Byong Chang Jeong
    • 2
  • Seong Il Seo
    • 2
  • Hyun Moo Lee
    • 2
  • Han Yong Choi
    • 2
  • Jong Wook Kim
    • 3
  • SangChul Lee
    • 4
  • Seok-Soo Byun
    • 4
  • Chang Wook Jeong
    • 5
  • Cheol Kwak
    • 5
  • Jin Seon Cho
    • 6
  • Hanjong Ahn
    • 7
    Email author
  • Seong Soo Jeon
    • 2
    Email author
  1. 1.Department of Urology, School of MedicineEwha Womans UniversitySeoulKorea
  2. 2.Department of Urology, Samsung Medical Center, School of MedicineSungkyunkwan UniversitySeoulKorea
  3. 3.Department of Urology, Guro HospitalKorea UniversitySeoulKorea
  4. 4.Department of Urology, Bundang HospitalSeoul National UniversitySeongnamKorea
  5. 5.Department of UrologySeoul National University HospitalSeoulKorea
  6. 6.Department of Urology, College of MedicineHallym UniversityChuncheonKorea
  7. 7.Department of Urology, Asan Medical Center, College of MedicineUniversity of UlsanSeoulKorea

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