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Biopsy-detected Gleason grade 5 tumor is an additional prognostic factor in metastatic hormone-sensitive prostate cancer

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Abstract
Purpose: A Gleason score ≥ 8, metastatic tumor burden, and visceral metastasis are known prognostic factors for patients with metastatic hormone-sensitive prostate cancer (mHSPC). Notably, however, these indicators have not been fully validated internationally. We aimed in this present study to further analyze the factors that influence the prognosis of mHSPC.

Methods: In this retrospective study, we identified 201 patients with newly diagnosed mHSPC between 2008 and 2014 and collected their clinical information. Cox proportional hazard regression models were used to identify prognostic factors in mHSPC.

Results: The mean age of the patients at presentation was 70 years (interquartile range (IQR), 64-76 years). The prostate-specific antigen level was 141 ng/mL (IQR, 58.8-464.5 ng/mL). Of the 201 study patients, 191 (94.5%) and 131 (65.2%) cases had a biopsy Gleason score ≥ 8 and grade 5, respectively. More than 4 metastases were detected in 134 patients. Castration-resistant prostate cancer (CRPC) was evident in 160 cases after a mean follow-up period of 46.6 months. By multivariable analysis, a Gleason grade of 5 and bone metastasis lesion count ≥ 4 were found to be significantly associated with CRPC-free survival (hazard ratio (HR), 1.45; 95% confidence interval (CI), 1.01-2.07) and (HR 2.02; 95% CI 1.39-2.92) and overall survival (HR 1.67 95%; CI 1.16-2.42) and (HR 1.67 95%; CI 1.16-2.41).

Conclusions: Bone metastases ≥ 4 and a Gleason grade 5 are independent prognostic factors for CRPC-free and overall survival in mHSPC. A Gleason grade 5 is therefore a new prognostic indicator in mHSPC.
Author(s)
Bumjin LimWonchul LeeYoon Soo KyungDalsan YouIn Gab JeongJun Hyuk HongHanjong AhnChoung-Soo Kim
Issued Date
2022
Type
Article
Keyword
Gleason grade 5Hormone-sensitive metastatic prostate cancerPrognosis
DOI
10.1007/s00432-021-03642-2
URI
https://oak.ulsan.ac.kr/handle/2021.oak/13818
Publisher
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
Language
한국어
ISSN
0171-5216
Citation Volume
148
Citation Number
3
Citation Start Page
727
Citation End Page
734
Appears in Collections:
Medicine > Nursing
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