Small transrectal ultrasound volume predicts clinically significant Gleason score upgrading after radical prostatectomy: Results from the SEARCH database

Ryan S. Turley, Robert J. Hamilton, Martha K. Terris, Christopher J. Kane, William J. Aronson, Joseph C. Presti, Christopher Amling, Stephen J. Freedland

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Purpose: Needle biopsy Gleason scores are often upgraded after pathological examination of the prostate following radical prostatectomy. It has been suggested that larger prostates would be associated with a greater risk of upgrading since a smaller percentage of the gland is sampled and, thus, the highest grade disease would more likely be missed, assuming an equal number of cores is taken from similar locations. We examined the likelihood of clinically relevant upgrading after radical prostatectomy as a function of transrectal ultrasound volume. Materials and Methods: We examined the association between transrectal ultrasound volume and upgrading (higher Gleason score category in the radical prostatectomy specimen than in the biopsy) in 586 men treated with radical prostatectomy between 1995 and 2006 in the SEARCH database who underwent at least a sextant biopsy using multivariate logistic regression. Transrectal ultrasound volume was categorized as 20 or less (in 71), 21 to 40 (in 334), 41 to 60 (in 123) and greater than 60 cm3 (in 58). Gleason score was examined as a categorical variable of 2-6, 3 + 4 and 4 + 3 or greater. Results: Overall 138 cases (24%) were upgraded, 80 (14%) were downgraded, and 368 (62%) had identical biopsy and pathological Gleason sum groups. Larger transrectal ultrasound volume was significantly associated with decreased likelihood of upgrading (p trend

Original languageEnglish (US)
Pages (from-to)523-527
Number of pages5
JournalJournal of Urology
Volume179
Issue number2
DOIs
StatePublished - Feb 2008
Externally publishedYes

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Neoplasm Grading
Prostatectomy
Databases
Biopsy
Prostate
Needle Biopsy
Logistic Models

Keywords

  • Biopsy, needle
  • Prostate
  • Prostatectomy
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Small transrectal ultrasound volume predicts clinically significant Gleason score upgrading after radical prostatectomy : Results from the SEARCH database. / Turley, Ryan S.; Hamilton, Robert J.; Terris, Martha K.; Kane, Christopher J.; Aronson, William J.; Presti, Joseph C.; Amling, Christopher; Freedland, Stephen J.

In: Journal of Urology, Vol. 179, No. 2, 02.2008, p. 523-527.

Research output: Contribution to journalArticle

Turley, Ryan S. ; Hamilton, Robert J. ; Terris, Martha K. ; Kane, Christopher J. ; Aronson, William J. ; Presti, Joseph C. ; Amling, Christopher ; Freedland, Stephen J. / Small transrectal ultrasound volume predicts clinically significant Gleason score upgrading after radical prostatectomy : Results from the SEARCH database. In: Journal of Urology. 2008 ; Vol. 179, No. 2. pp. 523-527.
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