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Disease‐specific death and metastasis do not occur in patients with Gleason score ≤6 at radical prostatectomy
Author(s) -
Kweldam Charlotte F.,
Wildhagen Mark F.,
Bangma Chris H.,
Leenders Geert J.L.H.
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12879
Subject(s) - medicine , prostatectomy , prostate cancer , interquartile range , metastasis , population , oncology , urology , cancer , environmental health
Objectives To assess the metastasis‐free survival ( MFS ) and disease‐specific survival ( DSS ) in men with Gleason score ≤6 prostate cancer at radical prostatectomy ( RP ). Patients and Methods We included 1101 consecutive RP patients operated between March 1985 to July 2013 at a single institution. The outcome variables were MFS and DSS . The postoperative survival was estimated by the Kaplan–Meier method. Results The Gleason score distribution of the study population (1101 patients) was Gleason score ≤6 (449, 41%), Gleason score 3 + 4 = 7 (436, 40%), Gleason score 4 + 3 = 7 (99, 9%) and Gleason score 8–10 (117, 11%). The median (interquartile range) postoperative follow‐up was 100 (48–150) months. During follow‐up 197 men (18%) died, of whom 42 (3.8%) died from prostate cancer‐related causes. In all, 19/1101 patients (1.7%) had documented lymph node metastasis at the time of RP : none with Gleason score ≤6, seven with Gleason score 3 + 4 = 7 (1.6%), six with Gleason score 4 + 3 = 7 (6.1%) and six with Gleason score 8–10 (5.1%). Distant metastasis occurred in 56/1101 patients (5.1%): none with Gleason score ≤6, 23 with Gleason score 3 + 4 = 7 (5.3%), 17 with Gleason score 4 + 3 = 7 (17%) and 16 with Gleason score 8–10 (14%). Disease‐specific death, stratified per Gleason‐score group was: none in ≤6, 16 (3.7%) in 3 + 4 = 7, 16 (16%) in 4 + 3 = 7 and 10 (8.5%) in 8–10 group. Conclusion No metastasis or disease‐specific death were seen in men with Gleason score ≤6 prostate cancer at RP , showing the negligible potential to metastasise in this large subgroup of patients with prostate cancer.