Old Men with Prostate Cancer Have Higher Risk of Gleason Score Upgrading and Pathological Upstaging After Initial Diagnosis: a Systematic Review and Meta-analysis

Overview

Journal World J Surg Oncol

Publisher Biomed Central

Specialties General Surgery
Oncology

Date 2021 Jan 21

PMID 33472645

Citations 7

Authors

Xiaochuan Wang

Yu Zhang

Zhengguo Ji

Peiqian Yang

Ye Tian

Affiliations

Soon will be listed here.

Abstract

Background: To evaluate the predictive performance of age for the risk of Gleason score change and pathologic upstaging.

Evidence Acquisition: Ovid MEDLINE, Ovid Embase, and the Cochrane Library were searched from inception until May 2020. Quality of included studies was appraised utilizing the Newcastle-Ottawa Quality Assessment Scale for case-control studies. The publication bias was evaluated by funnel plots and Egger's tests.

Evidence Synthesis: Our search yielded 27 studies with moderate-to-high quality including 84296 patients with mean age of 62.1 years. From biopsy to prostatectomy, upgrading and upstaging occurred in 32.3% and 9.8% of patients, respectively. Upgrading from diagnostic biopsy to confirmatory biopsy was found in 16.8%. Older age was associated with a significant increased risk of upgrading (OR 1.04, 95% CI 1.03-1.05), and similar direction of effect was found in studies focused on upgrading from diagnostic biopsy to confirmatory biopsy (OR 1.06, 95% CI 1.04-1.08). For pathologic upstaging within older men compared with younger, the pooled odds was 1.03 (95% CI 1.01-1.04).

Conclusion: Thorough consideration of age in the context of effect sizes for other factors not only prompts more accurate risk stratification but also helps providers to select optimal therapies for patients with prostate cancer.

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