ABSTRACT
Background: African ancestry is a known factor associated with the presentation and aggressiveness of prostate cancer (PC). Hispanic/Latino populations exhibit varying degrees of genetic admixture across Latin American countries, leading to diverse levels of African ancestry. However, it remains unclear whether genetic ancestry plays a role in the aggressiveness of PC in Hispanic/Latino patients. We explored the associations between genetic ancestry and the clinicopathological data in Hispanic/Latino PC patients from Colombia. Patients and methods: We estimated the European, Indigenous and African genetic ancestry, of 230 Colombian patients with localized/regionally advanced PC through a validated panel for genotypification of 106 Ancestry Informative Markers. We examined the associations of the genetic ancestry components with the Gleason Grade Groups (GG) and the clinicopathological characteristics. Results: No association was observed between the genetic ancestry with the biochemical recurrence or Gleason GG; however, in a two groups comparison, there were statistically significant differences between GG3 and GG4/GG5 for European ancestry, with a higher mean ancestry proportion in GG4/GG5. A lower risk of being diagnosed at an advanced age was observed for patients with high African ancestry than those with low African ancestry patients (OR: 0.96, CI: 0.92-0.99, p=0.03). Conclusion: Our findings revealed an increased risk of presentation of PC at an earlier age in patients with higher African ancestry compared to patients with lower African ancestry in our Hispanic/Latino patients.
ABSTRACT
INTRODUCTION: The aim of this article was to evaluate the effectiveness of the Gleason grade groups (GGG) system on a group of Argentinian patients with prostate cancer (PC) who underwent radical prostatectomy (RP). MATERIAL AND METHODS: We retrospectively studied 262 patients who underwent RP between 1996 and 2014. To determine the performance and validity of the GGG system, a Kaplan-Meier analysis and multivariate analysis with Cox proportional method were performed to evaluate biochemical recurrence, distance metastases and specific cancer mortality. The area under the curve (AUC) was calculated to compare new groups of degrees of the GGG system with the classical scheme of stratification into 3 groups. RESULTS: The median follow-up was 84 months. As the groups ascend, there is less confined organ disease (p <0.001) and greater extraprostatic extension (p <0.001), greater invasion of seminal vesicles (p <0.001) and greater lymph node involvement (p <0.001). The biochemical recurrence-free survival at 5 years was 68%, 55%, 22%, 9%, 0% of the 1-5 groups, respectively. Ten-years cancer-specific survival was 96%, 95%, 78%, 64%, 25% for group 1-5, respectively. In the multivariate analysis, the GGG system is presented as the only independent predictor of biochemical recurrence and specific cancer mortality. The AUC indicates that the GGG system has a higher prognostic discrimination compared to the classic 3-group system (6, 7, ≥8). CONCLUSIONS: The International Society of Urological Pathology (ISUP) GGG system is an independent predictor of biochemical recurrence and mortality from prostate cancer in patients treated with RP. The classification into 5 groups shows greater discrimination in the prognosis than the traditional Gleason classification.
ABSTRACT
INTRODUÇÃO: O adenocarcinoma de próstata corresponde a uma das neoplasias malignas mais frequentes em homens, comprometendo principalmente da sexta a oitava décadas. Algumas características histopatológicas do tumor, como grau de diferenciação, invasão capsular e escore de Gleason, podem ser correlacionadas com o prognóstico da doença. OBJETIVOS: Estimar a associação entre o escore de Gleason e fatores prognósticos em casos de adenocarcinoma prostático. MATERIAL E MÉTODO: O estudo avaliou 118 espécimes de prostatectomia radical provenientes do Laboratório de Patologia da ULBRA entre 2003 e 2008. Em cada caso foram determinados os seguintes dados: idade, lateralidade, estadiamento, escore total e padrões primário e secundário de Gleason, grau de diferenciação, presença de invasão capsular, angiolinfática e perineural e extensão extraprostática. Foram usados os testes do qui-quadrado e o teste exato de Fischer para verificar a associação entre as variáveis, considerando um nível de significância menor que 5 por cento. RESULTADOS: A idade média correspondeu a 63,86 anos. Observou-se a predominância do escore 6 de Gleason (55 casos - 46,61 por cento), de bilateralidade (72 casos - 61,02 por cento) e do estádio T2c (57 casos - 48,31 por cento). O escore de Gleason esteve associado a idade (0,001), lateralidade (p < 0,001), invasão capsular (p < 0,005), invasão angiolinfática (p < 0,001), invasão perineural (p < 0,05), extensão extraprostática (p < 0,001) e estadiamento (0,001). Foi encontrada uma associação significativa entre invasão capsular e idade (p < 0,01) e invasão perineural (p < 0,001). CONCLUSÃO: No adenocarcinoma prostático, a determinação do escore de Gleason corresponde a um dos principais fatores histológicos a serem descritos, apresentando relação significativa com outros critérios anatomopatológicos, como extensão, invasão perineural e angiolinfática e estadiamento.
INTRODUCTION: The prostate adenocarcinoma corresponds to one of the most frequent malignant neoplasias affecting 60 to 80 year old men. Some histopathological characteristics of the tumor, such as degree of differentiation, capsular invasion and Gleason score, may be correlated with the prognosis of the disease. OBJECTIVES: To assess the association of Gleason score and prognostic factors in cases of prostatic adenocarcinoma. MATERIAL AND METHOD: The study evaluated one hundred and eighteen specimens of radical prostatectomy from the laboratory of pathology of ULBRA between 2003 and 2008. In each case, the following data were recorded: age, laterality, staging, total score, primary and secondary patterns of Gleason, degree of differentiation, presence of capsular, angiolymphatic and perineural invasion and extraprostatic extension. Chi-square test and Fischer's exact test with significance < 5 percent were used. RESULTS: The mean age was 63.86. There was a prevalence of Gleason score 6 (55 cases - 46.61 percent), bilaterality (72 cases - 61.02 percent) and staging T2c (57 cases - 48.31 percent). Gleason score was associated with age (0.001), laterality (p < 0.001), capsular invasion (p < 0.005), angiolymphatic invasion (p < 0.001), perineural invasion (p < 0.05), extraprostatic invasion (p < 0.001) and staging (0.001). There was a significant association among capsular invasion, age (p < 0.01) and perineural invasion (p < 0.001). CONCLUSION: In prostate adenocarcinomas, the determination of Gleason score corresponds to one of the main histological factors to be described, showing significant relation with other anatomopathological criteria, such as extension, perineural and angiolymphatic invasion and staging.