Prediction of outcomes after radical prostatectomy in patients diagnosed with prostate cancer of biopsy Gleason score ≥ 8 via contemporary multi (≥ 12)-core prostate biopsy

Abstract

Objective: • To investigate the outcome of patients who underwent radical prostatectomy (RP) for prostate cancer of biopsy Gleason score ≥ 8 diagnosed via contemporary prostate biopsy.

Patients and methods: • We reviewed records of 151 patients who underwent RP for prostate cancer of biopsy Gleason score ≥ 8 detected via multi (≥ 12)-core prostate biopsy without any neoadjuvant or adjuvant treatment. • Preoperative predictors of pathologically organ-confined disease along with biochemical recurrence-free survival were analyzed via multivariate logistic regression and Cox proportional hazards model.

Results: • For 151 total subjects, 5-year estimated biochemical recurrence-free survival rate was 41.0%. Patients with pathologically organ-confined disease were observed to have much higher 5-year biochemical recurrence-free survival rate than those otherwise (72.1 vs 31.5%, P < 0.001). • Serum PSA level (P= 0.031) and maximum tumour length in a biopsy core (P= 0.005) were observed to be significant preoperative predictors of having pathologically organ-confined disease. • As for biochemical recurrence-free survival following RP, serum PSA (P= 0.023), biopsy Gleason score (P= 0.032), and percent of total tumour length in biopsy cores (P < 0.001) were observed be significant preoperative predictors on multivariate analysis.

Conclusion: • Among contemporary patients with biopsy Gleason score ≥ 8 who underwent RP alone, patients with pathologically organ-confined disease demonstrated significantly better biochemical outcome than others. Serum PSA level and maximum tumour length in a biopsy core, independent predictors of organ-confined disease, would be useful in the selection of candidates for RP among patients presenting with biopsy Gleason score ≥ 8.