TY  - JOUR
A1  - Höh, Benedikt
A1  - Flammia, Rocco
A1  - Hohenhorst, Lukas
A1  - Sorce, Gabriele
A1  - Chierigo, Francesco
A1  - Tian, Zhe
A1  - Saad, Fred
A1  - Gallucci, Michele
A1  - Briganti, Alberto
A1  - Terrone, Carlo
A1  - Shariat, Shahrokh F.
A1  - Graefen, Markus
A1  - Tilki, Derya
A1  - Kluth, Luis A.
A1  - Mandel, Philipp
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Up- and downgrading in single intermediate-risk positive biopsy core prostate cancer
T2  - Prostate international
N2  - Background: Up- and/or downgrading rates in single intermediate-risk positive biopsy core are unknown.
Methods: We identified single intermediate-risk (Gleason grade group (GGG) 2/GGG3) positive biopsy core prostate cancer patients (≤ cT2c and PSA ≤ 20 ng/mL) within the Surveillance, Epidemiology, and End Results (SEER) database (2010–2015). Subsequently, separate uni- and multivariable logistic regression models tested for independent predictors of up- and downgrading.
Results: Of 1,328 assessable patients with single core positive intermediate-risk prostate cancer at biopsy, 972 (73%) harbored GGG2 versus 356 (27%) harbored GGG3. Median PSA (5.5 vs 5.7; p = 0.3), median age (62 vs 63 years; p = 0.07) and cT1-stage (77 vs 75%; p = 0.3) did not differ between GGG2 and GGG3 patients. Of individuals with single GGG2 positive biopsy core, 191 (20%) showed downgrading to GGG1 versus 35 (4%) upgrading to GGG4 or GGG5 at RP. Of individuals with single GGG3 positive biopsy core, 36 (10%) showed downgrading to GGG1 versus 42 (12%) significant upgrading to GGG4 or GGG5 at RP. In multivariable logistic regression models, elevated PSA (10–20 ng/mL) was an independent predictor of upgrading to GGG4/GGG5 in single GGG3 positive biopsy core patients (OR:2.89; 95%-CI: 1.31–6.11; p = 0.007).
Conclusion: In single GGG2 positive biopsy core patients, downgrading was four times more often recorded compared to upgrading. Conversely, in single GGG3 positive biopsy core patients, up- and downgrading rates were comparable and should be expected in one out of ten patients.
KW  - Downgrading
KW  - Intermediate-risk
KW  - Prostate cancer
KW  - Single positive core biopsy
KW  - Upgrading
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/78549
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-785492
SN  - 2287-8882
VL  - 10
IS  - 1
SP  - 21
EP  - 27
PB  - Elsevier
CY  - Amsterdam
ER  -