Impact of primary Gleason grade on risk stratification for XXXX .

@entity1 @entity263 @entity5 @entity3 @entity1486
PURPOSE: To evaluate the primary Gleason grade (GG) in @entity263 for risk of non-organ-confined disease with the goal of optimizing radiotherapy treatment option counseling. METHODS: One thousand three hundred thirty-three @entity1 with pathologic GS7 were identified in the Duke Prostate Center research database. Clinical factors including age, race, clinical stage, @entity1486 at diagnosis, and pathologic stage were obtained. Data were stratified by @entity1486 and clinical stage at diagnosis into adapted D'Amico risk groups. Univariate and multivariate analyses were performed evaluating for association of primary GG with pathologic outcome. RESULTS: Nine hundred seventy-nine @entity1 had primary GG3 and 354 had GG4. On univariate analyses, GG4 was associated with an increased risk of non-organ-confined disease. On multivariate analysis, GG4 was independently associated with @entity3 ( @entity3 ) but not extracapsular extension. @entity1 with otherwise low-risk disease and primary GG3 had a very low risk of @entity3 (4%). CONCLUSIONS: Primary GG4 in GS7 @entity5 is associated with increased risk of @entity3 compared with primary GG3. Otherwise low-risk @entity1 with GS 3+4 have a very low risk of @entity3 and may be candidates for prostate-only radiotherapy modalities.
