Open Access

ARTICLE

Is there a progression of histologic grade from radical prostatectomy to local recurrence in patients with clinically isolated local recurrence following surgery?

R. Choo¹, L. Sugar², E. Hong¹, K. Mackenzie¹, G. DeBoer¹, C. Danjoux¹, G. Morton¹, L. Klotz²

1 Toronto Sunnybrook Regional Cancer Centre, University of Toronto, Toronto, Ontario, Canada
2 Sunnybrook and Women’s College Health Science Centre, University of Toronto, Toronto, Ontario, Canada
Address correspondence to Dr. Richard Choo, Toronto Sunnybrook Regional Cancer Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 Canada

Canadian Journal of Urology 2003, 10(5), 1981-1985.

Abstract

Objective: To evaluate whether there is any histologic progression from radical prostatectomy (RP) to local recurrence in patients with clinically isolated local recurrence following RP.
Methods and materials: A total of 43 patients with clinically isolated, biopsy proven, local recurrence following RP were retrospectively analyzed with respect to the change in Gleason score (GS) from RP to local recurrence. Central pathology review was undertaken for both RP and local recurrence biopsy specimens. The changes in primary and secondary Gleason grade (GG), and any potential correlation between the extent of GS change and other variables were also examined.
Results: Median age at the time of local recurrence was 67 years (range: 55-78). Median interval between RP and local recurrence was 3.6 years (range: 0.3-17.7). Eight had a short course (< 3 months) of hormone therapy prior to RP. Initial GS of RP specimens was 5, 6, 7, 8, and 9 in 1, 3, 29, 1, and 9 patients, respectively. At the time of local recurrence, GS was upgraded in 13, unchanged in 23, and downgraded in 7. The extent of GS change was correlated with the interval between RP and local recurrence, but not with pathological T stage or age.
Conclusion: There was no statistically significant change in GS from RP to local recurrence, although there was a trend toward a higher GS at the time of local recurrence. The extent of GS change was associated positively with the elapsed time to local recurrence.

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