Turkish Journal of Medical Sciences
Abstract
Background/aimTransrectal ultrasound-guided biopsy is the most commonly employed method in the diagnostic pathway of prostatic adenocarcinoma. Gleason score of the tumor is the critical tissue-based determinant of patient management after diagnosis, and main approach for low risk patients with grade group (GG) 1 disease is active surveillance rather than definitive interventions. However, a fair proportion of these cases is upgraded following radical prostatectomy (RP) if performed. We aimed to investigate the significance of clinicopathological parameters including PTEN protein in the prediction of higher final grade at radical prostatectomy in patients with biopsy diagnosis of GG1 prostatic carcinoma. Materials and methods33 patients who underwent robotic-assisted RP (RARP) for grade GG1 disease at prostate biopsy were evaluated retrospectively. Their clinical, radiological and pathological features were explored in addition to final histological grade in RP. Upgrade was defined as any increase in Gleason score from initial needle biopsy to pathological analysis of the entire surgical specimen. Expression of PTEN in prostate biopsy cores was evaluated through immunohistochemistry. Multivariate logistic regression was performed to detect independent predictors of tumor upgrading from biopsy to RP.ResultsThe final RP pathology revealed upgrading in 16 patients (48.5%) to GG2 disease. The statistics showed that PIRADS score (≤3 vs 4-5) of the index lesion and the number of involved cores in systematic biopsies (≤2 vs >2) were the only independent predictors of the presence of higher grade at RP (p<0.05). Rate of PTEN loss for upgrading and non-upgrading patients were 25% and 5.9%, respectively, however without statistical significance (p=0.175).ConclusionsmpMRI findings and number of tumor positive needle cores are useful parameters to apply for predicting higher grade disease in RPs of patients with GG1 tumor diagnosis after prostate biopsy. Immunohistochemical PTEN analysis on the other hand do not provide significant information in this respect.
Author ORCID Identifier
BARIŞ ESEN: 0000-0002-3117-4607
BENGİ GÜRSES: 0000-0002-2482-3445
ARİF ÖZKAN: 0000-0001-6534-5403
MERT KILIÇ: 0000-0003-1707-3890
YAKUP KORDAN: 0000-0002-9947-848X
TARIK ESEN: 0000-0002-0961-9374
DİLEK ERTOY BAYDAR: 0000-0003-0784-8605
DOI
10.55730/1300-0144.5962
Keywords
Gleason score, grade group 1, immunohistochemistry, multiparametric magnetic resonance imaging, phosphatase and tensin homolog, Prostate cancer, upgrade
First Page
231
Last Page
236
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
ESEN, BARIŞ; GÜRSES, BENGİ; ÖZKAN, ARİF; KILIÇ, MERT; KORDAN, YAKUP; ESEN, TARIK; and ERTOY BAYDAR, DİLEK
(2025)
"Predictors of Gleason score upgrading in patients with biopsy diagnosis of grade group 1 prostate cancer,"
Turkish Journal of Medical Sciences: Vol. 55:
No.
1, Article 26.
https://doi.org/10.55730/1300-0144.5962
Available at:
https://journals.tubitak.gov.tr/medical/vol55/iss1/26
