Four prognostic Gleason grading groups were considered, divided into scores of 2-4, 5-6, 7 and 8-10. To check
the discriminative power of the modified Gleason grading we compared the time of biochemical (prostate specific antigen) progression-free outcome according to prognostic groups between standard and revised grading.
Results: The greatest impact of the International Society of Urological Pathology consensus recommendations for Gleason grading was seen on the secondary pattern which had the lowest percentage of concordance and was reflected in a change toward higher Dinaciclib Gleason prognostic groups. Of 172 patients in whom the Gleason prognostic group was changed (to higher grades) based solely on the consensus criteria, 46 (26.7%) had higher preoperative prostate specific antigen, more extensive tumors and positive surgical margins, and
higher pathological stage. The revised Gleason grading identified in this series a higher number of patients in the aggressive prognostic group Gleason score 8-10 who had a significantly shorter time to biochemical progression-free outcome after radical prostatectomy (log rank p = 0.011).
Conclusions: The findings of this study indicate that the recommendations of the International Society of Urological Pathology are a valuable refinement of the standard Gleason grading system.”
“Purpose: We report the largest data set to date to our knowledge regarding outcomes for primary whole gland prostate cryoablation.
Materials and Methods: The COLD (Cryo On-Line Data) EPZ004777 cell line Registry consists of case report forms obtaining pretreatment and posttreatment information for patients undergoing whole gland prostate cryoablation. ID-8 A total of 1, 198 patients were stratified into low, intermediate and high risk groups. Biochemical success was defined according
to the traditional American Society for Therapeutic Radiology and Oncology definition (3 increases) and the newer (Phoenix) definition (nadir +2). Biopsy was performed at physician discretion but most commonly for cause if a patient had an increasing or suspicious prostate specific antigen.
Results: Average patient age was 69.8 +/- 7.5 years. Pretreatment prostate specific antigen was 9.6 +/- 8.6 ng/ml and median Gleason sum was 7 (range 4 to 10). Patients were followed for 24.4 +/- 25.9 months with 136 having minimum 5-year data. The 5-year biochemical disease-free status for the entire population was 77.1% +/- 2.1% (American Society for Therapeutic Radiology and Oncology) and 72.9% +/- 2.1% (Phoenix). Five-year American Society for Therapeutic Radiology and Oncology biochemical disease-free status was 84.7% +/- 4.5%, 73.4% +/- 4.3% and 75.3% +/- 3.7% for the low, moderate and high risk groups, respectively. Using the Phoenix definition the biochemical disease-free status was 91.1% +/- 2.9%, 78.5% +/- 3.6% and 62.2% +/- 4.9%, respectively. As predicted based on intentional preservation of some prostatic tissue, 72.5 +/- 1.