Men who have a localized prostate biopsy Gleason 9-10 with definitive local therapy face worse outcomes compared to those with biopsy Gleason 8 disease, according to a recent study published in The Journal of Urology.
Che-kai Tsao, MD, of the Division of Hematology and Medical Oncology at The Tisch Cancer Institute at Mount Sinai in New York observed a cohort of 847 patients with biopsy Gleason 8-10 disease who had received either radiation therapy (RT) or radical prostatectomy (RP) from January 2001 to December 2011.
They used multivariable Cox modeling to compare outcomes in Gleason score of 8 and 9-10 in terms of time to biochemical recurrence, time to metastases, and overall survival. At baseline, patients demonstrated similar characteristics between the two groups.
The researchers found that higher-grade disease was associated with an increased risk of developing metastatic disease, with an increased risk of death in Gleason 9-10, particularly among those treated with RP. Gleason 9-10 was also associated with higher PSA at diagnosis.
“Clinical trials incorporating newer approaches to Gleason 9-10 cancer are urgently needed,” the authors concluded.
In this study, authors want to examine the differences in outcome in patients with biopsy Gleason score 8 versus 9-10 who received definitive local therapy. Patients with localized biopsy Gleason 9-10 disease treated with definitive local therapy had worse outcomes compared to patients diagnosed with biopsy Gleason 8 disease.