Urological Science

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 31  |  Issue : 4  |  Page : 170--176

Initial prostate biopsy of grade group one: A study of pathological upgrade and biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy


Fan-Ching Hung, Chi-Shin Tseng, Chung-Hsin Chen, Hong-Chiang Chang, Chao-Yuan Huang, Yu-Chuan Lu 
 Department of Urology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

Correspondence Address:
Yu-Chuan Lu
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Number 7, Chung-Shan South Road, Taipei 100
Taiwan

Purpose: The aim of our study was to analyze the outcomes and predictive factors in patients with an initial biopsy grade group 1 (GG1) prostate cancer (PCa) at risk of GG upgrading. Materials and Methods: We performed a retrospective review of patients who had GG1 PCa at biopsy and were managed with robotic-assisted laparoscopic radical prostatectomy (RaLRP) from January 2012 to December 2018 and collected their clinical characteristics and pathological data. The primary outcomes were GG upgrading at RaLRP and biochemical recurrence-free survival (BCRFS) in these patients. The secondary outcome was to analyze the risk factors of pathological upgrades. Results: Among the 159 patients with initial prostate biopsy of GG1, 122 patients (76.7%) had GG upgrading based on the final pathology at RaLRP. Multivariable analysis showed that transrectal ultrasound (TRUS)-measured prostate volume <30 mL (odds ratio [OR] 4.727, P = 0.011), prostate-specific antigen density [PSAD] ≥0.2 ng/mL2 (OR 3.201, P = 0.019), magnetic resonance imaging (MRI)-measured prostate volume <30 mL (OR 3.892, P = 0.007), and PSAD ≥ 0.2 ng/mL2 (OR 2.65, P = 0.019) were independent predictive factors of GG upgrading. During 5 years of follow-up, patients who upgraded to GG3-5 had a significantly shorter time to biochemical recurrence than those who remained as GG1 (P = 0.001) or upgraded to GG2 (P = 0.008). Conclusion: The final pathology grading was underestimated in 76.7% of initial biopsy GG1 and may influence the BCRFS after RaLRP. Prostate volume <30 mL and PSAD ≥0.2 ng/mL2, measured by either MRI or TRUS, were significant predictive factors of biopsy GG1 upgrading.


How to cite this article:
Hung FC, Tseng CS, Chen CH, Chang HC, Huang CY, Lu YC. Initial prostate biopsy of grade group one: A study of pathological upgrade and biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy.Urol Sci 2020;31:170-176


How to cite this URL:
Hung FC, Tseng CS, Chen CH, Chang HC, Huang CY, Lu YC. Initial prostate biopsy of grade group one: A study of pathological upgrade and biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy. Urol Sci [serial online] 2020 [cited 2021 Sep 20 ];31:170-176
Available from: https://www.e-urol-sci.com/article.asp?issn=1879-5226;year=2020;volume=31;issue=4;spage=170;epage=176;aulast=Hung;type=0