Mp21-01 the weighted gleason score of prostate biopsy specimens improves the prediction of pathologic gleason score

You have accessJournal of UrologyProstate Cancer: Detection & Screening III1 Apr 2016MP21-01 THE WEIGHTED GLEASON SCORE OF PROSTATE BIOPSY SPECIMENS IMPROVES THE PREDICTION OF PATHOLOGIC GLEASON SCORE Eric Cho, Joshua Kaplan, Andrew Harbin, Anastasiya Kamenko, Frederick Ramsey, Jack Mydlo, Daniel Eun, and Adam Reese Eric ChoEric Cho More articles by this author , Joshua KaplanJoshua Kaplan More articles by this author , Andrew HarbinAndrew Harbin More articles by this author , Anastasiya KamenkoAnastasiya Kamenko More articles by this author , Frederick RamseyFrederick Ramsey More articles by this author , Jack MydloJack Mydlo More articles by this author , Daniel EunDaniel Eun More articles by this author , and Adam ReeseAdam Reese More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.635AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Biopsy Gleason score often differs from pathological Gleason score in patients treated with radical prostatectomy (RP) for prostate cancer. In this study, we developed the weighted Gleason score (wGS), a scoring system that accounts for the weighted average of all Gleason patterns present on prostate biopsy cores. We tested whether the wGS improves correlation between biopsy and pathological Gleason scores in patients undergoing RP. METHODS Using our institutional database of prostate cancer patients treated with RP, we determined the traditional biopsy Gleason score (tGS) and the weighted biopsy Gleason score (wGS) for each patient. The tGS was the highest individual Gleason score of any biopsy core on diagnostic biopsy. The wGS was determined by multiplying the Gleason score of each biopsy by the respective percent involvement of that biopsy core, and summing the values of all cores taken. This value, when divided by the sum of percent involvement, yielded the wGS. We then determined the pathological Gleason score (pGS) after RP, and correlated both tGS and wGS with pGS by generating a weighted Kappa score for each potential association. RESULTS A total of 130 men were included in this analysis. The table shows correlations of tGS and wGS with pGS. When compared to the tGS, wGS resulted in more frequent correlation with pGS (52.3% vs 48.4%), less frequent downgrading (31.5% vs 38.5%), and slightly more upgrading (16.2% vs 13.1%). The weighted Kappa score for wGS exceeded that of tGS (0.4398 vs. 0.3978), reflecting a better correlation of wGS with pGS. CONCLUSIONS These data suggest that wGS is a better predictor of pathologic Gleason score after RP than traditional Gleason scoring of prostate biopsy cores. This is likely due to the traditional practice of upgrading to the highest Gleason score of all prostate biopsy cores, which often results in overestimation of pathologic Gleason score. wGS eliminates this practice, resulting in less frequent downgrading with only a modest increase in upgrading on final pathology. Further research is needed to validate the improved risk stratification potentially offered by the wGS. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e244 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Eric Cho More articles by this author Joshua Kaplan More articles by this author Andrew Harbin More articles by this author Anastasiya Kamenko More articles by this author Frederick Ramsey More articles by this author Jack Mydlo More articles by this author Daniel Eun More articles by this author Adam Reese More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...