BACKGROUND: The presence of a tertiary Gleason grade (TGG) pattern in radical prostatectomy (RP) specimens has been described as associated with adverse pathology and a higher biochemical recurrence (BCR) rate after RP. OBJECTIVE: To assess the prevalence of a TGG in a contemporary, consecutive, single-centre RP series and its association with adverse pathology. DESIGN, SETTING, AND PARTICIPANTS: From January to August 2007, 800 eligible patients (no prior neoadjuvant hormonal therapy) underwent RP for clinically localised prostate cancer (pCA) in our institution. The presence of the third most prevalent Gleason pattern was documented, regardless of whether it was better or worse than the two predominant Gleason grades. MEASUREMENTS: The overall prevalence of a TGG was described. Uni- and multivariate logistic regression analyses tested the association between the presence of a TGG or=5% of the whole tumour volume and extracapsular extension (ECE), seminal vesicle invasion (SVI), positive surgical margins (PSM), and lymph node invasion (LNI). Subanalyses were performed to assess the impact of different TGGs at various Gleason scores. RESULTS AND LIMITATIONS: A TGG was reported in 180 RP specimens (22.5%). In univariate analysis, the presence of a TGG >/=5% was significantly associated with ECE, SVI, PSM, and LNI (por=5% showed an independent association with ECE and PSM (p
BACKGROUND: The presence of a tertiary Gleason grade (TGG) pattern in radical prostatectomy (RP) specimens has been described as associated with adverse pathology and a higher biochemical recurrence (BCR) rate after RP. OBJECTIVE: To assess the prevalence of a TGG in a contemporary, consecutive, single-centre RP series and its association with adverse pathology. DESIGN, SETTING, AND PARTICIPANTS: From January to August 2007, 800 eligible patients (no prior neoadjuvant hormonal therapy) underwent RP for clinically localised prostate cancer (pCA) in our institution. The presence of the third most prevalent Gleason pattern was documented, regardless of whether it was better or worse than the two predominant Gleason grades. MEASUREMENTS: The overall prevalence of a TGG was described. Uni- and multivariate logistic regression analyses tested the association between the presence of a TGG or=5% of the whole tumour volume and extracapsular extension (ECE), seminal vesicle invasion (SVI), positive surgical margins (PSM), and lymph node invasion (LNI). Subanalyses were performed to assess the impact of different TGGs at various Gleason scores. RESULTS AND LIMITATIONS: A TGG was reported in 180 RP specimens (22.5%). In univariate analysis, the presence of a TGG >/=5% was significantly associated with ECE, SVI, PSM, and LNI (por=5% showed an independent association with ECE and PSM (p