Clinical and pathologic outcome after radical prostatectomy for prostate cancer patients with a preoperative Gleason sum of 8 to 10 (pages 1265–1272)
Patrick J. Bastian, Mark L. Gonzalgo, William J. Aronson, Martha K. Terris, Christopher J. Kane, Christopher L. Amling, Joseph C. Presti Jr., Leslie A. Mangold, Elizabeth Humphreys, Jonathan I. Epstein, Alan W. Partin and Stephen J. Freedland
Article first published online: 9 AUG 2006 | DOI: 10.1002/cncr.22116
Men with prostate cancer and a biopsy Gleason sum of 8 to 10 are considered high-risk. The current study sought to identify whether there was a subset of men with high biopsy Gleason sums who would have a good pathologic and biochemical outcome with surgical monotherapy. The results from a tertiary care referral center and multiple equal-access medical centers demonstrate that the majority of men with a biopsy Gleason sum of ≥8 will have nonorgan-confined disease and experience a biochemical progression after radical prostatectomy. Even among men with organ-confined disease and negative surgical margins or pathologic Gleason sum <8, the majority of men experienced a prostate-specific antigen recurrence. The findings confirm the high-risk nature of these patients and suggest that these patients may be best served with multimodal therapy.