Mp79-04 gleason 6, stage t3 prostate cancer is associated with low rates of recurrence

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2016MP79-04 GLEASON 6, STAGE T3 PROSTATE CANCER IS ASSOCIATED WITH LOW RATES OF RECURRENCE Scott Wiener, Peter Haddock, Ilene Staff, Joseph Cusano, and Joseph Wagner Scott WienerScott Wiener More articles by this author , Peter HaddockPeter Haddock More articles by this author , Ilene StaffIlene Staff More articles by this author , Joseph CusanoJoseph Cusano More articles by this author , and Joseph WagnerJoseph Wagner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2002AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Most large series indicate the incidence of Gleason 6 prostate cancer extending beyond the capsule and/or into the seminal vesicles (T3) is <2%. Limited data exist describing the aggressiveness of cancer in this relatively rare sub-population. We retrospectively compared the incidence and outcomes of patients with Gleason 6/T3 prostate cancer compared to Gleason 6/T2, Gleason 7/T2, and Gleason 7/T3. METHODS We retrospectively reviewed all radical prostatectomies performed at our center from 1/2/03-8/14/15. The primary outcome was biochemical recurrence in the following cohorts: Gleason 6/T2, G7/T2, G6/T3 and G7/T3 disease. Demographics, diagnostic PSA, pre-operative D′ Amico risk, surgical margin and nerve sparing status, and use of salvage and adjuvant XRT were compared. RESULTS On final pathologic review of 3604 prostatectomies, 808 (24.9%), 1741 (53.6%), 50 (1.5%) and 649 (20%) patients were identified with G6/T2, G7/T2, G6/T3 and G7/T3 disease, respectively. Age and PSA at diagnosis were associated with elevated T stage and Gleason Score (p<0.001). No patients with Gleason 6 disease received adjuvant radiotherapy, while 0.3% of G7T2 and 3.2% of G7T3 were treated. Only two G6/T3 patients (4.0%) recurred versus 96 (14.8%) in the G7/T3 group (p=0.033). There was no difference in recurrence rate between G6T2 and G6/T3 (3.7% v. 4.0%, p=0.77). Time to recurrence (in patients that recurred) differed significantly between groups (p<0.001). CONCLUSIONS G6T3 disease was an uncommon diagnosis (1.5% of patients). Unlike Gleason 7 prostate cancer, where recurrence rates increase significantly between T2 and T3 disease (6.7% v. 14.8%, p=0.001), there is little difference in recurrence rates for G6/T2 and T3 prostate cancer. ASTRO/AUA Guidelines state physicians should offer adjuvant radiotherapy in cases with adverse pathologic findings at prostatectomy (e.g. seminal vesicle invasion, positive surgical margins, or extraprostatic extension) due to demonstrated reductions in biochemical recurrence, local recurrence, and clinical progression. Our data indicate this recommendation should be tempered for Gleason 6/T3 prostate cancer. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1035-e1036 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Scott Wiener More articles by this author Peter Haddock More articles by this author Ilene Staff More articles by this author Joseph Cusano More articles by this author Joseph Wagner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...