Extraprostatic extension of gleason 6 prostate cancer: single center experience

Objective: For Gleason Score (GS) 3+3:6 prostate cancer (PC) cases, recent guidelines recommend clinical follow-up instead of radical treatment due to complications. One of the most important disadvantages of clinical follow-up is that low-grade PC may include local aggressive behavior. Hence, our aim here was to investigate the incidence of extraprostatic extension (EPE), a local aggressive behavior, in GS6 PC cases. Material and Methods: We examined 119 materials diagnosed with prostatic adenocarcinoma (GS 3+3:6) with no tertiary pattern and that were sent to our department as radical prostatectomy materials between January 2010 – May 2019. We investigated how many of the materials had EPE. Results: We observed EPE in 16 (13.45%) of our cases. 5 of the cases had vesicula seminalis invasion (pT3b) and 11 had EPE and/or bladder neck invasion (pT3a) without vesicula seminalis invasion. Conclusion: Among our patients diagnosed with GS-6 PC, we observed EPE (pT3) in 13.45% and vesicula seminalis invasion (pT3b) in 4.2%, which suggests that the possibility of EPE is not uncommon in GS-6 PC. Based on these findings, we argue that patients with GS-6 PC under clinical follow-up should be followed more carefully for EPE. Keywords: prostate cancer; gleason score; extraprostatic extension