Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer

Blake B. Anderson*, Daniel T. Oberlin, Aria A. Razmaria, Bonnie Choy, Gregory P. Zagaja, Arieh L. Shalhav, Joshua J Meeks, Ximing J Yang, Gladell P. Paner, Scott E. Eggener

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background A significant proportion of men with Gleason score 6 (GS6) prostate cancer undergo treatment with radiation or surgery. Objective To assess pathologic stage of pure GS6 at radical prostatectomy (RP). Design, setting, and participants In the period 2003–2014, 7817 patients underwent RP at two institutions. Of 2502 patients with GS6 at surgery, 60 were identified as stage pT3a–b on initial pathologic review, 55 with pT3a (extraprostatic extension, EPE), and five with pT3b (seminal vesicle invasion; SVI). All cases of GS6 with pT3 disease underwent contemporary pathologic evaluation for Gleason grade, stage, and extent of EPE. At one institution, all GS≥7 pT3b cases were re-reviewed for downgrading. The 2014 International Society of Urological Pathology (ISUP) Gleason grading criteria and 2009 ISUP recommendations on pT3 staging were applied. Outcome measurements and statistical analysis Calculated incidence (%) of pT3a, pT3b, pT4, and lymph node-positive disease. Results and limitations Of the 60 GS6 pT3a–b cases identified in the period 2003–2014, seven (0.28% of entire GS6 cohort) with GS6 and pT3a were identified after re-review, all focal EPE. Among the re-examined cohort, no cases of GS6 with pT3b were observed. None of the 132 GS≥7 pT3b cases were downgraded to GS6. Limitations include partial embedding of specimens and separate pathologic review at each institution. Conclusions In a large prostatectomy cohort, GS6 never had seminal vesicle invasion (0%) and was very rarely (0.28%) associated with extraprostatic extension. Patient summary GS6 prostate cancer rarely spreads outside the prostate. A new finding in this study was that GS6 prostate cancer never spread to the seminal vesicles.

Original languageEnglish (US)
Pages (from-to)455-460
Number of pages6
JournalEuropean urology
Volume72
Issue number3
DOIs
StatePublished - Sep 2017

Fingerprint

Neoplasm Grading
Prostatic Neoplasms
Seminal Vesicles
Prostatectomy
Pathology
Prostate
Lymph Nodes

Keywords

  • Male
  • Neoplasm grading
  • Prostatectomy
  • Prostatic neoplasms
  • Seminal vesicles

ASJC Scopus subject areas

  • Urology

Cite this

Anderson, B. B., Oberlin, D. T., Razmaria, A. A., Choy, B., Zagaja, G. P., Shalhav, A. L., ... Eggener, S. E. (2017). Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer. European urology, 72(3), 455-460. https://doi.org/10.1016/j.eururo.2016.11.028
Anderson, Blake B. ; Oberlin, Daniel T. ; Razmaria, Aria A. ; Choy, Bonnie ; Zagaja, Gregory P. ; Shalhav, Arieh L. ; Meeks, Joshua J ; Yang, Ximing J ; Paner, Gladell P. ; Eggener, Scott E. / Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer. In: European urology. 2017 ; Vol. 72, No. 3. pp. 455-460.
@article{979ae7f971bd432eab3b52877d4cdf8e,
title = "Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer",
abstract = "Background A significant proportion of men with Gleason score 6 (GS6) prostate cancer undergo treatment with radiation or surgery. Objective To assess pathologic stage of pure GS6 at radical prostatectomy (RP). Design, setting, and participants In the period 2003–2014, 7817 patients underwent RP at two institutions. Of 2502 patients with GS6 at surgery, 60 were identified as stage pT3a–b on initial pathologic review, 55 with pT3a (extraprostatic extension, EPE), and five with pT3b (seminal vesicle invasion; SVI). All cases of GS6 with pT3 disease underwent contemporary pathologic evaluation for Gleason grade, stage, and extent of EPE. At one institution, all GS≥7 pT3b cases were re-reviewed for downgrading. The 2014 International Society of Urological Pathology (ISUP) Gleason grading criteria and 2009 ISUP recommendations on pT3 staging were applied. Outcome measurements and statistical analysis Calculated incidence ({\%}) of pT3a, pT3b, pT4, and lymph node-positive disease. Results and limitations Of the 60 GS6 pT3a–b cases identified in the period 2003–2014, seven (0.28{\%} of entire GS6 cohort) with GS6 and pT3a were identified after re-review, all focal EPE. Among the re-examined cohort, no cases of GS6 with pT3b were observed. None of the 132 GS≥7 pT3b cases were downgraded to GS6. Limitations include partial embedding of specimens and separate pathologic review at each institution. Conclusions In a large prostatectomy cohort, GS6 never had seminal vesicle invasion (0{\%}) and was very rarely (0.28{\%}) associated with extraprostatic extension. Patient summary GS6 prostate cancer rarely spreads outside the prostate. A new finding in this study was that GS6 prostate cancer never spread to the seminal vesicles.",
keywords = "Male, Neoplasm grading, Prostatectomy, Prostatic neoplasms, Seminal vesicles",
author = "Anderson, {Blake B.} and Oberlin, {Daniel T.} and Razmaria, {Aria A.} and Bonnie Choy and Zagaja, {Gregory P.} and Shalhav, {Arieh L.} and Meeks, {Joshua J} and Yang, {Ximing J} and Paner, {Gladell P.} and Eggener, {Scott E.}",
year = "2017",
month = "9",
doi = "10.1016/j.eururo.2016.11.028",
language = "English (US)",
volume = "72",
pages = "455--460",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "3",

}

Anderson, BB, Oberlin, DT, Razmaria, AA, Choy, B, Zagaja, GP, Shalhav, AL, Meeks, JJ, Yang, XJ, Paner, GP & Eggener, SE 2017, 'Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer', European urology, vol. 72, no. 3, pp. 455-460. https://doi.org/10.1016/j.eururo.2016.11.028

Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer. / Anderson, Blake B.; Oberlin, Daniel T.; Razmaria, Aria A.; Choy, Bonnie; Zagaja, Gregory P.; Shalhav, Arieh L.; Meeks, Joshua J; Yang, Ximing J; Paner, Gladell P.; Eggener, Scott E.

In: European urology, Vol. 72, No. 3, 09.2017, p. 455-460.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer

AU - Anderson, Blake B.

AU - Oberlin, Daniel T.

AU - Razmaria, Aria A.

AU - Choy, Bonnie

AU - Zagaja, Gregory P.

AU - Shalhav, Arieh L.

AU - Meeks, Joshua J

AU - Yang, Ximing J

AU - Paner, Gladell P.

AU - Eggener, Scott E.

PY - 2017/9

Y1 - 2017/9

N2 - Background A significant proportion of men with Gleason score 6 (GS6) prostate cancer undergo treatment with radiation or surgery. Objective To assess pathologic stage of pure GS6 at radical prostatectomy (RP). Design, setting, and participants In the period 2003–2014, 7817 patients underwent RP at two institutions. Of 2502 patients with GS6 at surgery, 60 were identified as stage pT3a–b on initial pathologic review, 55 with pT3a (extraprostatic extension, EPE), and five with pT3b (seminal vesicle invasion; SVI). All cases of GS6 with pT3 disease underwent contemporary pathologic evaluation for Gleason grade, stage, and extent of EPE. At one institution, all GS≥7 pT3b cases were re-reviewed for downgrading. The 2014 International Society of Urological Pathology (ISUP) Gleason grading criteria and 2009 ISUP recommendations on pT3 staging were applied. Outcome measurements and statistical analysis Calculated incidence (%) of pT3a, pT3b, pT4, and lymph node-positive disease. Results and limitations Of the 60 GS6 pT3a–b cases identified in the period 2003–2014, seven (0.28% of entire GS6 cohort) with GS6 and pT3a were identified after re-review, all focal EPE. Among the re-examined cohort, no cases of GS6 with pT3b were observed. None of the 132 GS≥7 pT3b cases were downgraded to GS6. Limitations include partial embedding of specimens and separate pathologic review at each institution. Conclusions In a large prostatectomy cohort, GS6 never had seminal vesicle invasion (0%) and was very rarely (0.28%) associated with extraprostatic extension. Patient summary GS6 prostate cancer rarely spreads outside the prostate. A new finding in this study was that GS6 prostate cancer never spread to the seminal vesicles.

AB - Background A significant proportion of men with Gleason score 6 (GS6) prostate cancer undergo treatment with radiation or surgery. Objective To assess pathologic stage of pure GS6 at radical prostatectomy (RP). Design, setting, and participants In the period 2003–2014, 7817 patients underwent RP at two institutions. Of 2502 patients with GS6 at surgery, 60 were identified as stage pT3a–b on initial pathologic review, 55 with pT3a (extraprostatic extension, EPE), and five with pT3b (seminal vesicle invasion; SVI). All cases of GS6 with pT3 disease underwent contemporary pathologic evaluation for Gleason grade, stage, and extent of EPE. At one institution, all GS≥7 pT3b cases were re-reviewed for downgrading. The 2014 International Society of Urological Pathology (ISUP) Gleason grading criteria and 2009 ISUP recommendations on pT3 staging were applied. Outcome measurements and statistical analysis Calculated incidence (%) of pT3a, pT3b, pT4, and lymph node-positive disease. Results and limitations Of the 60 GS6 pT3a–b cases identified in the period 2003–2014, seven (0.28% of entire GS6 cohort) with GS6 and pT3a were identified after re-review, all focal EPE. Among the re-examined cohort, no cases of GS6 with pT3b were observed. None of the 132 GS≥7 pT3b cases were downgraded to GS6. Limitations include partial embedding of specimens and separate pathologic review at each institution. Conclusions In a large prostatectomy cohort, GS6 never had seminal vesicle invasion (0%) and was very rarely (0.28%) associated with extraprostatic extension. Patient summary GS6 prostate cancer rarely spreads outside the prostate. A new finding in this study was that GS6 prostate cancer never spread to the seminal vesicles.

KW - Male

KW - Neoplasm grading

KW - Prostatectomy

KW - Prostatic neoplasms

KW - Seminal vesicles

UR - http://www.scopus.com/inward/record.url?scp=85008221025&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008221025&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2016.11.028

DO - 10.1016/j.eururo.2016.11.028

M3 - Article

C2 - 27986368

AN - SCOPUS:85008221025

VL - 72

SP - 455

EP - 460

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 3

ER -