Clinical characteristics of patients after radical prostatectomy for prostate cancer:a comparison between Gleason score 3+4 and Gleason score 4+3 / 第二军医大学学报

ABSTRACT

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 of 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.