Benefits and harms of the new prostate cancer grade grouping on the prediction of long-term oncological outcomes in patients after radical prostatectomy.
Int J Urol
; 28(4): 390-395, 2021 Apr.
Article
em En
| MEDLINE
| ID: mdl-33406542
ABSTRACT
OBJECTIVE:
To investigate whether the new prostate cancer grade groups model provides significant predictive value and better patient stratification on tumor progression after radical prostatectomy compared with the former Gleason grading models.METHODS:
Men treated at a tertiary center by radical prostatectomy between 2005 and 2017 were analyzed. The outcomes of interest were clinical progression-free and cancer-specific survival. Multivariate Cox regression analysis, C-index and decision curve analysis were carried out using three-tier (Gleason score 6, 7 and 8-10), four-tier (Gleason score 6, 7, 8 and 9-10) and new grade groups model.RESULTS:
In total, 1759 men were included in the analysis. At a median of 87 months (interquartile range 51-134 months) of follow up, clinical progression was detected in 78 (4.4%) and cancer-related death in 42 (2.4%) patients. The hazard ratio of clinical progression-free was 2.3, 5.7, 5.2 and 29.5; the hazard ratio of cancer-specific survival was 1.7, 3.2, 4.8 and 11.8 in the grade groups 2-5, relative to grade group 1, respectively. The grade groups model had higher C-index in comparison with four- and three-tier grading models for clinical progression-free survival 0.88 versus 0.85 versus 0.83 and for cancer-specific survival 0.82 versus 0.80 versus 0.80, respectively. In the decision curve analysis, the grade groups model shows marginally better net benefit on clinical progression-free and cancer-specific survival.CONCLUSIONS:
The new model shows better performance in comparison with former Gleason grading models on the prediction of long-term oncological outcomes.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Recidiva Local de Neoplasia
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Male
Idioma:
En
Revista:
Int J Urol
Assunto da revista:
UROLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Lituânia