756 Is the Cumulative Linear Length (CLL) of Gleason Pattern 4 (GP4) in Prostate Biopsies of Grade Group II and III Prostate Cancer a Good Predictor of Radical Prostatectomy (RP) Findings and Outcomes. Our Institutional Experience

Document Type

Conference Proceeding

Publication Date

3-24-2025

Publication Title

Lab Invest

Keywords

adult, aged, clinical outcome, cohort analysis, conference abstract, controlled study, distant metastasis, female, follow up, Gleason score, human, human tissue, involved margin, lymph node metastasis, major clinical study, male, middle aged, needle biopsy, prostate, prostate biopsy, prostate cancer, radical prostatectomy, retrospective study, seminal vesicle, tumor volume

Abstract

Disclosures: Omar Abbas: None; Kairui Sun: None; Mohamed Alhamar: None; Vipulkumar Dadhania: None; Khaleel Al-Obaidy: None; Nilesh Gupta: None; Oudai Hassan: None Background: In Prostate biopsies, Gleason Score (GS)/ Grade Group (GG) and tumor size have been used as markers to predict RP findings and clinical outcomes. In this study, we examined the significance of the CLL of GP4 in prostate biopsies of GG II and III prostate cancer to determine if it is a useful marker to predict RP findings and clinical outcomes. Design: The study was approved by our institutional review board (IRB). All consecutive prostate needle biopsies undertaken in 2016 with highest GS of 7 (GG II and III) and subsequent RP at our institution were included. All cases were signed out by specialized urologic pathologists. Detailed pathological findings were collected from our pathology archives. Clinical information was collected from medical records. The CLL of GP4 was calculated by multiplying the percentage of GP4 in each core by the length of the core involved and then adding these to get the CLL of GP4 in each case. Statistical analysis was performed using Mann-Whitney U test and Chi-squared test. Results: Overall, 95 patients were included in our study. Median age was 62. Of the 95 patients, 48/95 (50.5%) had extraprostatic extension (EPE) on RP, 12/95 (12.6%) had seminal vesicle invasion (SVI) on RP, 35/95 (36.8%) had positive resection margins and 11/94 (11.7%) had lymph node metastasis (LNM). On follow-up, 14/95 (14.7%) had disease recurrence (biochemical or local recurrence), while 3/95 (3.2%) distant metastasis. CLL of GP4 was significantly associated with EPE (p = 0.029). In addition, using a cutoff of ≥2 mm, GP4 CLL was significantly associated with EPE (p = 0.037). There were no significant association between GP4 CLL and SVI, positive resection margins, lymph node metastasis, distant metastasis and disease recurrence. [Formula presented] [Formula presented] Conclusions: Our results show that the CLL of GP4 in prostate biopsies of GG II and III is significantly associated with extraprostatic extension (EPE) on subsequent RP with a cutoff of 2 mm of GP4. These findings may be useful in stratifying patients with small tumor volume for conservative (CLL < 2 mm) versus definitive management ( CLL ≥ 2 mm) options. Our overall findings may be used in deciding optimal management options for patients with small foci of GG II and III prostate cancer in needle biopsies.

Volume

105

Issue

3

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