Low-Grade Prostate Cancers Rarely Metastasize

In a study, not a single case of metastatic disease developed among 449 men who had a tumor grade of Gleason 6 or less at radical prostatectomy.
In a study, not a single case of metastatic disease developed among 449 men who had a tumor grade of Gleason 6 or less at radical prostatectomy.

Prostate cancer (PCa) patients with a tumor grade of Gleason 6 or less at the time of radical prostatectomy (RP) are extremely unlikely to progress to metastatic disease or die from their cancer, according to a new study published online ahead of print in BJU International.

Charlotte F. Kweldam, MD, of Erasmus Medical Center in Rotterdam, The Netherlands, and colleagues studied 1,101 consecutive patients who underwent RP from 1985 and 2013. Of these, 449 (41%) had a Gleason score of 6 or less, 436 (40%) had a Gleason score of 3 + 4, 99 (9%) had a Gleason score of 4 + 3, and 117 (11%) had a Gleason score of 8–10 at surgery.

The median follow-up after surgery was 100 months, during which 197 patients (18%) died, 42 (2.8%) from PCa-related causes. No PCa-related deaths occurred among patients with Gleason 6 or less. Distant metastases occurred in 56 men (5.1%), none of whom had a Gleason score of 6 or less, the researchers reported.

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