Among prostate cancer patients with a Gleason score (GS) 7 after radical prostatectomy, those with a tertiary Gleason 5 model are more likely to experience biochemical recurrence (BCR) than those without a model tertiary 5, according to a study.

In a study of 350 radical prostatectomy patients with GS 3 + 4 or 4 + 3 disease, the risk of BCR was twice as high in patients with tertiary Gleason 5, Lu Yang, MD, PhD, and colleagues at West China Hospital of Sichuan University, and colleagues reported in OncoTarget and therapy. The effect of the tertiary Gleason 5 model in GS 4 + 3 disease was significantly stronger than in GS 3 + 4. The risk of BCR was 2.5 times higher in men with primary Gleason 4 disease and tertiary Gleason 5 model. Neoadjuvant hormone therapy, positive surgical margin, and stage of tumor lymph node metastasis.

Although there has been consensus on the relevance of the tertiary Gleason 5 model for more advanced prostate cancer, its relevance for BCR is still controversial, explained Dr. Yang’s team. “Evidence, including this study, suggests that Gleason’s current scoring system should be updated to include TGP5 [tertiary Gleason pattern 5]. “Further studies with larger sample sizes are needed to fully test these associations,” they added.

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Li J, Guo Y, Qiu S et al. Significance of the tertiary Gleason 5 model in patients with Gleason score 7 after radical prostatectomy: a retrospective cohort study. OncoTargets Therapy. 2019: 12 7157-7164