FACTORS PREDICTING A POSSIBLE INCREASE OF GLEASON SCORE AFTER RADICAL PROSTATECTOMY IN PATIENTS WITH WELL-DIFFERENTIATED PROSTATE CANCER

Introduction The discrepancy between the Gleason score (GS) of the prostate biopsy and those after the radical prostatectomy (RP) is a well-known event. This is important for the patients because some of them, at least initially, prefer active surveillance, not active treatment. Aim To investigate the factors which can predict a possible increase in GS after RP in patients with well-differentiated (GS ≤ 6) prostate cancer (PCa). Methods The patients are divided into three groups. Group 1-GS of the biopsy is equal to those of the RP. Group 2- GS of the biopsy increases after the RP. Group 3- GS of the biopsy decreases after the RP. The information was collected and analyzed using IBM SPSS version 23. Results The patients available for analysis are 78- 32 patients in group 1, 34 patients in group 2, and 12 patients in group 3. A statistically significant difference in the prostate volumes and PSA density (PSAD) of the patients of the three groups is found. Discussion According to literature data patients with well-differentiated PCa (GS ≤ 6) are most likely to have their GS upgraded. That is why we studied several preoperative parameters (age, PSA, PSAD, prostate volume and presence of a palpable nodule in the prostate) in order to find a possible association with a GS-upgrade. Conclusion Higher PSAD and lower prostate volume are associated with a possible increase in GS. PSA, age, and the presence of a palpable nodule do not demonstrate a difference between the three groups.