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Gleason drift in the NIHR P rotec T study
Author(s) -
Oxley Jon,
Simpkin Andrew,
Goepel John,
Varma Murali,
Griffiths David,
Grigor Ken,
Mayer Nick,
Warren Anne,
Deshmukh Nayneeta,
Bhattarai Selina,
Dormer John,
Hounsome Luke,
Adamczyk Lukasz A,
Metcalfe Christopher,
Lane J Athene,
Davis Michael,
Donovan Jenny L,
Neal David E,
Hamdy Freddy C,
Robinson Mary C
Publication year - 2015
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12549
Subject(s) - perineural invasion , prostate cancer , medicine , biopsy , odds ratio , odds , cohort , prostate specific antigen , urology , prostate biopsy , cancer , gastroenterology , logistic regression
Aims There is increasing evidence of G leason score ( GS ) drift in prostatic core biopsies during the last two decades. The P rotec T study is a randomized controlled study and provides an excellent cohort to study the effect of time, prostate‐specific antigen ( PSA ) level, perineural invasion, tumour length and age on GS . Methods and results The P rotec T study recruited men in the United Kingdom between 1999 and 2010. The Gleason scores were grouped into four categories ≤3 + 3, 3 + 4, 4 + 3 and ≥4 + 4 for analysis. Data from England between 2000 and 2012 were also available. A total of 3282 biopsies containing cancer were analysed. For each year of the ProtecT study, the odds of being diagnosed with a higher GS category increased by 4.9%. Higher GS was also associated with perineural invasion, increasing tumour length, age and PSA level. While biopsy GS from England was incomplete, it also showed a marked decrease in GS five and six tumours during the same period. Conclusion There was GS drift from 3 + 3 to 3 + 4 with time in the ProtecT study, but there appeared to be no significant change in percentage of GS 4 + 3 or higher. This drift was less dramatic when compared to GS in the rest of England.