Prostate cancer outcomes of men with biopsy Gleason score 6 and 7 without cribriform or intraductal carcinoma

Aim of the study: Gleason score (GS) 3 + 4 = 7 prostate cancer patients with presence of cribriform or intraductal carcinoma (7(+)) have a worse disease-specific survival than those without. The aim of this study was to compare the clinicopathologic characteristics and patient outcomes of men with biopsy GS 3 + 4 = 7 without cribriform or intraductal carcinoma (7(-)) to those with GS 3 + 3 = 6. Materials and methods: We included all patients from the first screening round of the European Randomized Study of Screening for Prostate Cancer (1993-2000) with a revised GS = cT3 than those with GS 6 (all P < .001). GS 7(-) patients did not have a poorer biochemical recurrence-free survival (BCRFS) after radical prostatectomy than GS 6 patients (log-rank P = .13), whereas those with GS 7(+) had (log-rank P = .05). In multivariable analyses, biopsy GS 7(-) was not associated with poorer BCRFS after radical prostatectomy (hazard ratio [HR], 1.3; 95% confidence interval [CI]: 0.67-2.4; P = .47) or radiotherapy (HR, 0.88; 95% CI: 0.51-1.5; P = .63). GS 7(+) was independently associated with poorer BCRFS after radical prostatectomy (HR, 3.0; 95% CI: 1.1-7.8; P = .03), but not after radiotherapy (HR, 1.2; 95% CI: 0.58-2.3; P = .67). Conclusions: Men with biopsy GS 7(-) prostate cancer have similar BCRFS after radical prostatectomy or radiotherapy to those with GS 6 and may be candidates for active surveillance as long as other inclusion criteria such as on PSA and tumour volume are met. (C) 2016 Elsevier Ltd. All rights reserved