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首页> 外文期刊>Urology >Risk stratification of men with Gleason score 7 to 10 tumors by primary and secondary Gleason score: results from the SEARCH database.
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Risk stratification of men with Gleason score 7 to 10 tumors by primary and secondary Gleason score: results from the SEARCH database.

机译：格里森评分为7至10的男性按原发和继发格里森评分的风险分层：来自SEARCH数据库的结果。

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OBJECTIVES: Gleason score 4+3 prostate cancer is associated with worse clinicopathologic outcomes than is Gleason score 3+4. Whether the increased risk associated with Gleason score 4+3 disease is equivalent to that of Gleason score 4+4 or greater is unclear. METHODS: We reviewed the data from two separate cohorts pulled from the Shared Equal Access Regional Cancer Hospital database. The first consisted of 374 men with biopsy Gleason score 3+4 or greater disease and the second of 636 men with radical prostatectomy (RP) Gleason score 3+4 or greater disease. We estimated the odds ratios of unfavorable surgical pathologic findings for the biopsy Gleason score categories using logistic regression analysis. Using a Cox proportional hazards regression model, we estimated the relative risk of biochemical progression associated with each biopsy and RP Gleason score category. RESULTS: In the biopsy Gleason score cohort, a Gleason score of 4+3 was associated with an increased risk of extracapsular extension (P 0.01) and seminal vesicle invasion (P <0.001) relative to a biopsy Gleason score of 3+4. A biopsy Gleason score of 4+3 was associated with a similar risk of adverse pathologic findings relative to a biopsy Gleason score of 4+4 or greater (all P >0.10), except for higher grade pathologic tumors among men with a biopsy Gleason score of 4+4 or more (P = 0.001). After adjusting for multiple clinical characteristics, a biopsy Gleason score of 4+3 was associated with an increased recurrence risk relative to a biopsy Gleason score of 3+4 (P = 0.001), but a similar progression risk as that for a biopsy Gleason score of 4+4 or more (P = 0.53). In the RP Gleason cohort, and after adjustment for multiple clinicopathologic features, an RP Gleason score of 4+3 was associated with increased progression risk relative to an RP Gleason score of 3+4 (P = 0.03), but similar progression risk as that for an RP Gleason score of 4+4 or more (P = 0.24). CONCLUSIONS: In a multicenter database using pooled data from multiple pathologists, Gleason scores 4+3 and 4+4 or more exhibited similar clinicopathologic outcomes.
机译：目的：格里森评分4 + 3的前列腺癌与格里森评分3 + 4相比，其临床病理结果更差。目前尚不清楚与格里森评分4 + 3疾病相关的增加的风险是否等于格里森评分4 + 4或更高的风险。方法：我们回顾了来自共享平等访问区域癌症医院数据库的两个独立队列的数据。第一个由374例活检的Gleason评分为3 + 4或更高的男性组成，第二个由636例有根治性前列腺切除术（RP）的Gleason评分为3 + 4或更高的男性组成。我们使用逻辑回归分析估计了活检格里森评分类别的不利手术病理学发现的比值比。使用Cox比例风险回归模型，我们估计了与每个活检和RP Gleason评分类别相关的生化进展的相对风险。结果：在活检格里森评分队列中，相对于活检格里森评分3 + 4，格里森评分4 + 3与包膜外延伸（P 0.01）和精囊侵袭（P <0.001）的风险增加相关。相对于4 + 4或更高的活检Gleason评分，活检Gleason评分4 + 3与类似的不良病理发现风险相关（所有P> 0.10），但活检Gleason评分较高的病理肿瘤除外4 + 4或更多（P = 0.001）。在针对多种临床特征进行调整后，相对于3 + 4的活检Gleason评分，活检的Gleason评分4 + 3与复发风险增加相关（P = 0.001），但与活检Gleason评分相似的进展风险4 + 4或更多（P = 0.53）。在RP Gleason队列中，在针对多种临床病理特征进行了调整之后，相对于RP Gleason评分为3 + 4，RP Gleason得分为4 + 3与增加的进展风险相关（P = 0.03），但与之相似的进展风险RP Gleason评分为4 + 4或更高（P = 0.24）。结论：在使用来自多个病理学家的汇总数据的多中心数据库中，格里森得分4 + 3和4 + 4或更高表现出相似的临床病理结果。

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