Risk Factors of Patients with Prostate Cancer Upgrading for International Society of Urological Pathology Grade Group 1 After Radical Prostatectomy

Ozgur, Abdurrahman
Ozgur, Gunal
Sahin, Bahadir
Filinte, Deniz
Tinay, Ilker
cam, Haydar Kamil
Turkeri, Levent
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Dergi Adı
Objective: This study aimed to determine the predictive factors for patients whose International Society of Urological Pathology (ISUP) score was upgraded in radical prostatectomy (RP) pathologies with a prostate biopsy pathology of ISUP grade group 1. Materials and Methods: Among patients who underwent RP in our clinic within 10 years, 158 patients with prostate biopsy pathology of ISUP grade group 1 were examined retrospectively. Age, serum prostate-specific antigen (PSA) level, prostate biopsy ISUP grade group, number of cores taken in the prostate biopsy, number of tumor-positive cores, RP pathology ISUP grade group, and pathological stage were evaluated. Results: The mean age (+/- standard) of the 158 patients whose prostate biopsy pathology was ISUP grade group 1 were 64.07 (+/- 6.6). ISUP group upgrading was detected in 47 patients (29.7\%). The mean PSA value of these patients was 10.6 ng/mL (+/- 6.9). The mean PSA value of the other 111 patients without ISUP group upgrading was 7.98 ng/mL (+/- 4.9). The serum PSA level was significantly higher in patients with upgraded ISUP in the RP pathology (p=0.02). The percentage of tumor-positive cores in the group with ISUP group upgrading (37\%) was significantly higher than that in the group without ISUP group upgrading (27\%) (p=0.01). The detection rates of surgical margin positivity (42.6\% vs. 18\%), capsule invasion (55.3\% vs. 19.8\%), and seminal vesicle invasion (23.6\% vs. 3.6\%) were also significantly higher in the upgraded ISUP group after RP (p<0.05). Conclusion: The results of this trial suggest that active surveillance may not be an appropriate option for patients with biopsy ISUP grade group 1 with PSA level >10 ng/mL. Moreover, the presence of a higher number and percentage of tumor-positive cores constituted risks of ISUP group upgrading with concomitant poor pathological outcomes such as surgical margin positivity, capsule invasion, and seminal vesicle invasion.
Anahtar kelimeler
Prostate cancer, international society of urological pathology score, radical prostatectomy