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01-02-2018 | Original Article

Evaluation of tumor morphologies and association with biochemical recurrence after radical prostatectomy in grade group 5 prostate cancer

Authors: Trevor A. Flood, Nicola Schieda, Jordan Sim, Rodney H. Breau, Chris Morash, Eric C. Belanger, Susan J. Robertson

Published in: Virchows Archiv | Issue 2/2018

Abstract

We assessed Gleason pattern 5 (GP5) and other prostatic adenocarcinoma (PCa) morphologies to determine their association with biochemical recurrence (BCR). A search for grade group 5 PCa with radical prostatectomy (RP) yielded 49 patients. RPs were reviewed for %GP5 and morphologies (sheets, single cells, cords, small solid cylinders, solid medium to large nests with rosette-like spaces [SMLNRS], comedonecrosis, cribriform glands, glomerulations, intraductal carcinoma of the prostate [IDC-P], and prostatic ductal adenocarcinoma [PDCa]). Prevalence of morphologies was as follows: single cells 100%, cribriform glands 98.7%, cords 85.7%, IDC-P 77.6%, comedonecrosis 53.1%, sheets 49.0%, small solid cylinders 49.0%, PDCa 44.9%, glomerulations 34.7%, and SMLNRS 14.3%. From 28 patients who were treated with RP as monotherapy, 64.3% (18/28) had BCR. Comedonecrosis, sheets, small solid cylinders, IDC-P, and PDCa were significantly associated with BCR. Number of morphologies on RP and %GP5 were higher in patients with BCR (6.8 ± 2.1 versus 3.7 ± 2.9%; P < 0.001 and 26.9 ± 16.8 versus 11.4 ± 14.1%; P = 0.02) with area under ROC curve of 0.89 (confidence intervals [CI] 0.77–1.00). Sensitivity/specificity was 77.8/80.0% for predicting BCR when ≥ 5 morphologies were present and 0.79 (CI 0.60–0.99) with sensitivity/specificity of 66.7/80.0% for predicting BCR when ≥ 15% GP5 was present. Hazard ratio for BCR was higher with increasing number of morphologies (1.23, CI 1.02–1.49; P = 0.034) but not %GP5 (0.99, CI 0.97–1.02, P = 0.622). Our results indicate that GP5 morphologies may represent a biologically heterogeneous group and that an increasing number of PCa morphologies on RP is strongly associated with an increased risk of BCR.

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Title: Evaluation of tumor morphologies and association with biochemical recurrence after radical prostatectomy in grade group 5 prostate cancer
Authors: Trevor A. Flood
Nicola Schieda
Jordan Sim
Rodney H. Breau
Chris Morash
Eric C. Belanger
Susan J. Robertson
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Virchows Archiv / Issue 2/2018
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-017-2241-9

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Evaluation of tumor morphologies and association with biochemical recurrence after radical prostatectomy in grade group 5 prostate cancer

Abstract

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Abstract

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