Post-RP Outcomes Differ for Gleason 8, 9-10 Prostate Cancer

Gleason 9-10 tumors are associated with a greater risk of biochemical and clinical recurrence, but not overall survival.
Gleason 9-10 tumors are associated with a greater risk of biochemical and clinical recurrence, but not overall survival.

NEW ORLEANS—Patients with Gleason 9 or 10 prostate tumors have worse oncologic outcomes after radical prostatectomy (RP) than those with Gleason 8 tumors, study findings presented at the 2015 American Urological Association annual meeting suggest.

Weichen Xu, MD, and colleagues at the University of Southern California in Los Angeles studied 360 RP patients found to have Gleason 8, 9, or 10 prostate tumors on final pathology. Compared with patients who had Gleason 8 cancer, those with Gleason 9–10 tumors had a significant 60% increased risk of biochemical recurrence and 1.9 times increased risk of clinical recurrence, after controlling for preoperative PSA level, pathologic stage, use of adjuvant radiotherapy, and use of neoadjuvant or adjuvant hormone deprivation therapy. Overall survival did not differ significantly between the groups.

The study population had a median age of 66 years. The median follow-up for the Gleason 8 and Gleason 9-10 patients was 10.0 and 8.6 years, respectively.

Of the 360 patients, 227 and 133 patients had Gleason 8 and Gleason 9–10 tumors. Significantly fewer Gleason 8 than Gleason 9–10 patients had non-organ-confined (55.1% vs. 71.4%).

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