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Factors Predictive of Prostate Cancer Grade Changes from Biopsy to Radical Prostatectomy

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European School of Oncology
European School of Oncology
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UPGRADING/DOWNGRADING OF PROSTATE CANCER FROM BIOPSY TO RADICAL PROSTATECOMY: INCIDENCE AND PREDICTIVE FACTORS Jonathan I. Epstein, M.D.   Professor of Pathology, Urology, Oncology The Johns Hopkins Hospital, Baltimore, MD
Incidence – Problems with Methodology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Upgrading Incidence < 6 vs. > 7 ,[object Object],[object Object],[object Object],[object Object]
Upgrading Incidence < 6 to > 7 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
JHH Data ,[object Object],[object Object],[object Object],[object Object],[object Object]
Upgrading Incidence < 6 to > 7 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Downgrading Incidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Biopsy 3+4=7 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Biopsy 4+3=7 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Biopsy 4+4=8 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Up or Downgrading ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Up or Downgrading ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prior Studies Not Predictors of Upgrading ,[object Object],[object Object]
JHH Data ,[object Object],[object Object],[object Object],[object Object]
Prior Studies Major Predictors of Upgrading ,[object Object],[object Object],[object Object],[object Object]
Sampling ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sampling ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sampling ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sampling in Saturation Biopsies ,[object Object],[object Object],[object Object],[object Object],[object Object]
Serum PSA Levels ,[object Object],[object Object],[object Object]
PSA (ng/ml) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
%Free PSA & PSAV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prostate Size ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
PSAD (PSA/Volume) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Extent of Cancer on Bx ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Perineural Invasion (PNI) ,[object Object],[object Object],[object Object],[object Object]
Imaging ,[object Object],[object Object],[object Object]
JHH Univariate Analysis – Upgrade From Biopsy GS6 to Higher ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
JHH MVA Predict Upgrade from 6 to >6 ,[object Object],[object Object],[object Object],[object Object]
JHH MVA Predict Upgrade from 347 to >347 ,[object Object],[object Object]
JHH MVA Predict Downgrade from 347 to 6 ,[object Object],[object Object],[object Object]
 
 
Validating Chun Nomogram ,[object Object],[object Object],[object Object],[object Object]
Prognosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object]
 

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Factors Predictive of Prostate Cancer Grade Changes from Biopsy to Radical Prostatectomy

  • 1. UPGRADING/DOWNGRADING OF PROSTATE CANCER FROM BIOPSY TO RADICAL PROSTATECOMY: INCIDENCE AND PREDICTIVE FACTORS Jonathan I. Epstein, M.D.   Professor of Pathology, Urology, Oncology The Johns Hopkins Hospital, Baltimore, MD
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