Most Read Articles
Tristan Manalac, 11 Jul 2018
Gestational exposure to grain products fortified with folic acid appears to be linked to a lower risk of psychosis in offspring, according to a recent study.
Pearl Toh, 10 Jul 2018
A dual-hormone artificial pancreas (DAP) with a rapid delivery of insulin and pramlintide in a fixed ratio improves glycaemic control and reduces glucose variability in adults with type 1 diabetes (T1D) compared with first-generation artificial pancreas delivering insulin alone, according to a study presented at ADA 2018.
4 days ago
Chocolate consumption is not associated with risk of coronary heart disease (CHD), stroke or both combined in postmenopausal women free of pre-existing major chronic disease, a study suggests.
Pearl Toh, 5 days ago
More intensive lowering of LDL-C levels was associated with a progressively greater survival benefit than less intensive approach, when the baseline LDL-C levels were ≥100 mg/dL, reveals a meta-analysis of 34 randomized trials.

Biopsy Gleason pattern 5 tied to recurrence, metastasis, mortality in high-risk prostate cancer

29 Nov 2017

Preoperative biopsy Gleason grade (4 + 4 vs any Gleason pattern 5) subclassification of high-risk prostate cancer identifies men at highest risk for progression, according to a study. Furthermore, any Gleason 5 on biopsy correlates with a higher risk of metastasis, as well as prostate cancer-specific and overall mortality.

The authors assessed men with biopsy Gleason sum 8-10 prostate cancer treated with radical prostatectomy. The patients were divided into those with Gleason 4 + 4 vs those with any pattern 5 (ie, Gleason 3 + 5, 5 + 3, 4 + 5, 5 + 4 or 5 + 5).

Kaplan-Meier, log rank test and Cox proportional hazards models were used to analyse the predictors of biochemical recurrence, metastases, and prostate cancer-specific and overall survival.

A total of 634 men at high risk were identified. Of these, 394 (62 percent) had Gleason 4 + 4 and 240 (38 percent) had Gleason pattern 5 on biopsy. There was no significant difference in baseline characteristics between the groups.

Multivariable analysis revealed that men at high risk with Gleason pattern 5 vs Gleason 4 + 4 had no difference in the risk of biochemical recurrence (hazard ratio [HR], 1.26; 95 percent CI, 0.99 to 1.61; p=0.065). However, patients with any Gleason 5 on biopsy had significantly higher risk for metastasis (HR, 2.55; 1.50 to 4.35; p=0.001), prostate cancer-specific mortality (HR, 2.67; 1.26 to 5.66; p=0.010) and overall mortality (HR, 1.60; 1.09 to 2.34; p=0.016).

“Grouping all Gleason 8-10 tumours together as high-risk lesions may fail to fully stratify men at highest risk for poor outcomes,” according to researchers.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Oncology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Tristan Manalac, 11 Jul 2018
Gestational exposure to grain products fortified with folic acid appears to be linked to a lower risk of psychosis in offspring, according to a recent study.
Pearl Toh, 10 Jul 2018
A dual-hormone artificial pancreas (DAP) with a rapid delivery of insulin and pramlintide in a fixed ratio improves glycaemic control and reduces glucose variability in adults with type 1 diabetes (T1D) compared with first-generation artificial pancreas delivering insulin alone, according to a study presented at ADA 2018.
4 days ago
Chocolate consumption is not associated with risk of coronary heart disease (CHD), stroke or both combined in postmenopausal women free of pre-existing major chronic disease, a study suggests.
Pearl Toh, 5 days ago
More intensive lowering of LDL-C levels was associated with a progressively greater survival benefit than less intensive approach, when the baseline LDL-C levels were ≥100 mg/dL, reveals a meta-analysis of 34 randomized trials.