Studying the differences between pre-surgical and post-surgical Gleason scores is clearly “in fashion.” A third group has now reported that about 60 percent of their patients have a different Gleason score on biopsy than they do when the Gleason score is reassessed after surgery.
Vira et al. set out to investigate whether other specific preoperative patient characteristics might affect differences between biopsy-based (pre-surgical) Gleason scores (bGS) and pathological (post-surgical) Gleason scores (pGS). They were also trying to understand whether the bGS data is still important to prediction of outcomes once one knows the pGS (for patients undergoing radical prostatectomy).
They assessed data from 1,088 men, with a median follow-up of 56 months, dividing the patients into three groups by pGS: ≤ 6, 7, and 8-10. Only 41.1 percent of patients had the same bGS and pGS, but other preoperative patient characteristics appear to have minimal effect on the likelihood that bGS and pGS resulst will be the same (or different). They further demonstrated that a higher (or lower) pGS compared with the bGS had a significant, independent effect on risk for recurrence: specifically a one-unit change in GS was associated with a 15 percent change in risk for recurrence.