Dataset Information

Should all prostate needle biopsy Gleason score 4?+?4?=?8 prostate cancers be high risk? Implications for shared decision-making and patient counselling.

ABSTRACT:

Objectives

To estimate the probability of downgrading to Gleason score ?7 at radical prostatectomy for men with a prostate needle biopsy demonstrating Gleason score 8 (4?+?4).

Methods

This is a retrospective review of men with Gleason score 8 (4?+?4) prostate cancer on needle biopsy who then underwent a radical prostatectomy at the Karmanos Cancer Institute or the University of Michigan. Men with any pattern 5 on the diagnostic biopsy were excluded. The objective was to estimate the proportion of patients whose tumors were downgraded to Gleason score ?7 at radical prostatectomy and to identify clinical and biopsy parameters associated with downgrading.

Results

Median age of our cohort was 63 years (IQR: 59, 67.5) and median follow-up was 15 months (IQR: 7, 37). Of the 105 men that met inclusion criteria, 59% (62/105) were downgraded to Gleason score ?7 at radical prostatectomy. Having ?2 cores demonstrating Gleason score 8, ?50% maximal tumor involvement of any individual core positive for Gleason score 8, or the presence of Gleason pattern 3 (such as 3?+?4, 4?+?3, or 3?+?3) in other biopsy cores were all independently associated with downgrading in our multivariable model. Depending on the absence, presence, or combination of these 3 factors, patients had an estimated 6% to 82% probability of having their tumor downgraded at radical prostatectomy.

Conclusions

Men with low volume Gleason 8 (4?+?4) and/or the presence Gleason pattern 3 on prostate needle biopsy often have their tumors downgraded at radical prostatectomy. The presence of these preoperative biopsy parameters could affect pretreatment counseling and impact patient management.

SUBMITTER: Ginsburg K

PROVIDER: S-EPMC7054147 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Should all prostate needle biopsy Gleason score 4 + 4 = 8 prostate cancers be high risk? Implications for shared decision-making and patient counselling.

Ginsburg Kevin K Cole Adam I AI Silverman Michael E ME Livingstone Joan J Smith Daryn W DW Heilbrun Lance K LK Shi Dongping D Mehra Rohit R Sakr Wael A WA Morgan Todd M TM Cher Michael L ML

Urologic oncology 20191129 3

<h4>Objectives</h4>To estimate the probability of downgrading to Gleason score ≤7 at radical prostatectomy for men with a prostate needle biopsy demonstrating Gleason score 8 (4 + 4).<h4>Methods</h4>This is a retrospective review of men with Gleason score 8 (4 + 4) prostate cancer on needle biopsy who then underwent a radical prostatectomy at the Karmanos Cancer Institute or the University of Michigan. Men with any pattern 5 on the diagnostic biopsy were excluded. The objective was to estimate t ...[more]

PMID: 31791703

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Project description:Background. Multiple studies have shown that digitally mediated decision aids help prepare patients for medical decision making with their providers. However, few studies have investigated whether decision-support preferences differ between non-English-speaking and English-speaking Latino men with limited literacy. Objective. To identify and compare health information seeking patterns, preferences for information presentation, and interest in digital decision aids in a sample of Southern Californian underserved Latino men with newly diagnosed prostate cancer at a county hospital. Methods. We conducted semistructured, in-depth telephone interviews with 12 Spanish-speaking and 8 English-speaking Latino men using a purposive sampling technique. Following transcription of taped interviews, Spanish interviews were translated. Using a coding protocol developed by the team, two bilingual members jointly analyzed the transcripts for emerging themes. Coder agreement exceeded 80%. Differences were resolved through discussion. Results. Thematic differences between groups with different preferred languages emerged. Most respondents engaged in online health information seeking using cellphones, perceived a paternalistic patient-provider relationship, and expressed willingness to use hypothetical digital decision aids if recommended by their provider. English speakers reported higher digital technology proficiency for health-related searches. They also more frequently indicated family involvement in digital search related to their condition and preferred self-guided, web-based decision aids. In comparison, Spanish speakers reported lower digital technology proficiency and preferred family-involved, coach-guided, paper and visual decision aids. English speakers reported substantially higher levels of formal education. Conclusion. Preferences regarding the use of digital technology to inform prostate cancer treatment decision making among underserved Latino men varied depending on preferred primary language. Effective preparation of underserved Latino men for shared decision making requires consideration of alternative approaches depending on level of education attainment and preferred primary language.

Dataset Information

Should all prostate needle biopsy Gleason score 4?+?4?=?8 prostate cancers be high risk? Implications for shared decision-making and patient counselling.

Objectives

Methods

Results

Conclusions

Publications

Should all prostate needle biopsy Gleason score 4 + 4 = 8 prostate cancers be high risk? Implications for shared decision-making and patient counselling.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Should all prostate needle biopsy Gleason score 4?+?4?=?8 prostate cancers be high risk? Implications for shared decision-making and patient counselling.

Objectives

Methods

Results

Conclusions

Publications

Should all prostate needle biopsy Gleason score 4 + 4 = 8 prostate cancers be high risk? Implications for shared decision-making and patient counselling.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Should all prostate needle biopsy Gleason score 4 + 4 = 8 prostate cancers be high risk? Implications for shared decision-making and patient counselling.