کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2752125 1149545 2014 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The Effect of Differing Gleason Scores at Biopsy on the Odds of Upgrading and the Risk of Death From Prostate Cancer
ترجمه فارسی عنوان
تأثیر نمرات متفاوت گلیسون در بیوپسی بر احتمال پیشرفت و خطر مرگ از سرطان پروستات
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
چکیده انگلیسی

Introduction/BackgroundThe GS is an established prostate cancer prognostic factor. Whether the presence of differing GSs at biopsy (eg, 4+3 and 3+3), which we term ComboGS, improves the prognosis that would be predicted based on the highest GS (eg, 4+3) because of decreased upgrading is unknown. Therefore, we evaluated the odds of upgrading at time of radical prostatectomy (RP) and the risk of PCSM when ComboGS was present versus absent.Patients and MethodsLogistic and competing risks regression were performed to assess the effect that ComboGS had on the odds of upgrading at time of RP in the index (n = 134) and validation cohorts (n = 356) and the risk of PCSM after definitive therapy in a long-term cohort (n = 666), adjusting for known predictors of these end points. We calculated and compared the area under the curve using a receiver operating characteristic analysis when ComboGS was included versus excluded from the upgrading models.ResultsComboGS was associated with decreased odds of upgrading (index: adjusted odds ratio [AOR], 0.14; 95% confidence interval [CI], 0.04-0.50; P = .003; validation: AOR, 0.24; 95% CI, 0.11-0.51; P < .001) and added significantly to the predictive value of upgrading for the in-sample index (P = .02), validation (P = .003), and out-of-sample prediction models (P = .002). ComboGS was also associated with a decreased risk of PCSM (adjusted hazard ratio, 0.40; 95% CI, 0.19-0.85; P = .02).ConclusionDiffering biopsy GSs are associated with a lower odds of upgrading and risk of PCSM. If validated, future randomized noninferiority studies evaluating deescalated treatment approaches in men with ComboGS could be considered.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Genitourinary Cancer - Volume 12, Issue 5, October 2014, Pages e181–e187
نویسندگان
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