UPGRADE score: a new scoring system in predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer

dc.authorscopusid57188972324
dc.authorscopusid57194181662
dc.authorscopusid56999899900
dc.authorscopusid57200746662
dc.authorscopusid56441505800
dc.authorscopusid7102082956
dc.authorwosidAnıl, Hakan/ABE-4814-2022
dc.authorwosidKaramık, Kaan/AAR-2899-2020
dc.contributor.authorKaramik, Kaan
dc.contributor.authorAnil, Hakan
dc.contributor.authorYildiz, Ali
dc.contributor.authorGuezel, Ahmet
dc.contributor.authorAkdemir, Serkan
dc.contributor.authorArslan, Murat
dc.date.accessioned2024-12-15T15:40:46Z
dc.date.available2024-12-15T15:40:46Z
dc.date.issued2024
dc.departmentOkan Universityen_US
dc.department-temp[Karamik, Kaan] Kemer State Hosp, Dept Urol, TR-07980 Antalya, Turkiye; [Anil, Hakan] Med Pk Seyhan Hosp, Dept Urol, TR-01010 Adana, Turkiye; [Yildiz, Ali; Arslan, Murat] Okan Univ, Fac Med, Dept Urol, TR-34940 Istanbul, Turkiye; [Guezel, Ahmet] Aydin State Hosp, Dept Urol, TR-09000 Aydin, Turkiye; [Akdemir, Serkan] Tinaztepe Hosp, Dept Urol, TR-35390 Izmir, Turkiyeen_US
dc.description.abstractPathological upgrading poses a significant challenge in treatment decision-making, particularly for patients considered for active surveillance (AS). This study aimed to devise a novel scoring system to predict the risk of upgrading in patients with biopsy Gleason grade group 1 prostate cancer. We conducted a retrospective review of 235 patients who underwent radical prostatectomy between February 2014 and June 2022. Data on patient age, prostate-specific antigen (PSA) level, body mass index, clinical T-stage, prior biopsy history, Prostate Imaging-Reporting and Data System (PIRADS) score, time interval from biopsy to surgery, and pathological outcomes were collected. After a comprehensive review of the literature, multivariate analyses identified seven factors associated with upgrading in prostate cancer patients after radical prostatectomy: uninformative prior biopsy sample, PSA level, greatest percentage of tumor involvement, radiological PIRADS score, age, delay from biopsy to surgery and extension of positive cores. These factors were integrated into our devised U.P.G.R.A.D.E. model to form a scoring system. The U.P.G.R.A.D.E. score was calculated based on the cumulative score of these variables. The predictive performance of the U.P.G.R.A.D.E. scoring system was assessed, revealing a cohort with a mean age of 64.22 +/- 5.88 years and a mean PSA value of 8.92 +/- 5.05 ng/mL. The pathological samples of 95 patients (40.6%) were upgraded, and the upgraded patients exhibited significantly higher U.P.G.R.A.D.E. scores (p <0.001). The area under the receiver operating characteristic (AUROC) curve for the U.P.G.R.A.D.E. scoring system demonstrated robust predictive ability for upgrading (AUROC = 0.952; 95% Confidence interval (CI): 0.926-0.978; p < 0.001). In addition, a higher U.P.G.R.A.D.E. score was strongly associated with an increased risk of upgrading in biopsy Gleason grade group 1 patients, suggesting potential limitations for active surveillance eligibility in these individuals. Further validation studies are warranted to confirm these initial findings.en_US
dc.description.woscitationindexScience Citation Index Expanded - Social Science Citation Index
dc.identifier.citation0
dc.identifier.doi10.22514/jomh.2024.171
dc.identifier.endpage116en_US
dc.identifier.issn1875-6867
dc.identifier.issn1875-6859
dc.identifier.issue10en_US
dc.identifier.scopus2-s2.0-85209147079
dc.identifier.scopusqualityQ3
dc.identifier.startpage111en_US
dc.identifier.urihttps://doi.org/10.22514/jomh.2024.171
dc.identifier.urihttps://hdl.handle.net/20.500.14517/7515
dc.identifier.volume20en_US
dc.identifier.wosWOS:001352405900010
dc.identifier.wosqualityQ4
dc.language.isoenen_US
dc.publisherMre Pressen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectProstate canceren_US
dc.subjectPathologyen_US
dc.subjectUpgradingen_US
dc.subjectScoring systemen_US
dc.titleUPGRADE score: a new scoring system in predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate canceren_US
dc.typeArticleen_US
dspace.entity.typePublication

Files