Background/Aim: To evaluate the impact on biochemical relapse of clinically significant GS upgrade.
Materials and Methods: 3403 patients were selected. We considered “clinically significant” any GS change from biopsy to final radical prostatectomy sample.
Biochemical-recurrence-Free Survival (BFS) Kaplan-Meier curves were plotted. The associations of GS change from biopsy to prostatectomy and lymphadenectomy data were investigated.
Results: GS risk classes were confirmed in 66.9% of patients, upgraded in 28.2% and downgraded in 5.0%. Comparing upgraded to unchanged patients, upgraded GS patients have a BCR risk being intermediate between unchanged lower and higher class. GS change is not associated to total number of biopsy cores (p=0.80) nor to positive ones (p=0.98). A higher bGS is related to a more radical surgical approach with a lower incidence of nerve-sparing techniques (from 37.9% to 6.4%) and a higher percentage of lymphadenectomies (from 57.3% to 97.1%).
Conclusion: The study shows clear intermediate behaviour of GS upgraded cases in between lower and higher GS risk classes.
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