Résumé
Objective: To compare the clinical characteristics of patients with Gleason score 3+4 and Gleason score 4+3 after radical prostatectomy for prostate cancer. Methods: The clinical records of patients who underwent radical retropubic prostatectomy in our hospital from 2001 to 2006 were retrospectively analyzed. Thirty-seven patients with a Gleason score of 7 after operation were divided into 2 groups, Gleason score 3+4 group and Gleason score 4+3 group, according to major grading. The patients were followed up for biochemical recurrence and distant metastases. Radioimmunoassay was used to detect the serum prostate-specific antigen (PSA) level. Kaplan-Meier method was used to compare the progression-free survival curves and Cox regression model was used to analyze the independent factors influencing the disease progression. Results: The rates of extraprostatic extension at radical prostatectomy were not significantly different between 3+4 and 4+3 groups (21.1% vs 33.3%, P=0.462). The non-progression survival time of 3+4 group was markedly longer than that of 4+3 group (P= 0.030). Cox regression model showed that Gleason primary grade was an independent factor o[prognosis (P=0.033). 4+3 group had a higher risk for biochemical recurrence. Conclusion: Prostate cancers of Gleason score 7 with different grades have different biologic behaviors. The prognoses of patients in 3+4 group and 4+3 group are different after operation. It is quite feasible to further classify the patients with Gleason 7 according to major grades.