Table 5.
Factors predictive of RP specimen Gleason group upgrading in univariate and multivariate logistic regressionb)
| Univariate analysis |
Multivariate analysis |
|||||
|---|---|---|---|---|---|---|
| OR | 95% CI | P | OR | 95% CI | P | |
| Age at diagnosis | 0.98 | 0.97–0.99 | 0.008 | – | ||
| Y of diagnosis (biopsy) | ||||||
| 2009 | Reference | |||||
| 2010 | 1.0 | 0.8–1.3 | 0.6 | – | ||
| 2011 | 0.8 | 0.6-1.1 | 0.3 | |||
| 2012 | 0.9 | 0.7–1.1 | 0.4 | |||
| 2013 | 0.7 | 0.6–0.9 | 0.03 | |||
| 2014 | 0.5 | 0.4–0.7 | < 0.001 | |||
| Diagnostic method | ||||||
| TRUS | Reference | |||||
| TURP | 1.4 | 0.9–2.2 | 0.09 | |||
| Transperineal biopsy | 0.6 | 0.5–0.8 | 0.005 | 0.6 | 0.5–0.8 | < 0.001 |
| Preoperative serum PSA level (ng/mL) | 0.9 | 0.9–1.0 | 0.5 | a) | – | – |
| Clinical categories at diagnosis | ||||||
| cT1 | Reference | – | – | – | ||
| cT2 | 0.8 | 0.7–1.0 | 0.1 | |||
| cT3/4 | 0.6 | 0.4–0.8 | 0.006 | |||
| No. of biopsy cassettes | 1.0 | 0.9–1.0 | 0.8 | a) | – | – |
| No. of positive biopsy cassettes | 0.9 | 0.8–0.9 | < 0.001 | |||
| Positive biopsy cassettes (%) | ||||||
| < 25 | Reference | Reference | ||||
| 25–62.5 | 0.6 | 0.5–0.7 | < 0.001 | 0.7 | 0.6–0.8 | 0.002 |
| > 62.5 | 0.5 | 0.4–0.6 | < 0.001 | 0.6 | 0.5–0.8 | < 0.001 |
| Interval between biopsy & surgery (d) | ||||||
| < 40 | Reference | |||||
| 40–99 | 1.4 | 1.1–1.6 | < 0.001 | 1.3 | 1.1–1.6 | 0.002 |
| > 99 | 3.1 | 2.6–3.7 | < 0.001 | 3.0 | 2.4–3.8 | < 0.001 |
| Surgical approach | ||||||
| Robot-assisted LRP | Reference | a) | ||||
| LRP | 0.7 | 0.6–1.0 | 0.09 | – | – | – |
| Open retropubic RP | 0.9 | 0.8–1.0 | 0.6 | – | – | – |
| Hospital where biopsy/RP performed | ||||||
| Public/public | Reference | Reference | ||||
| Public/private | 1.3 | 0.9–1.9 | 0.07 | 1.6 | 1.0–2.3 | 0.01 |
| Private/public | 0.8 | 0.6–1.2 | 0.4 | 0.7 | 0.5–1.1 | 0.1 |
| Private/private | 0.6 | 0.5–0.8 | < 0.001 | 0.9 | 0.7–1.1 | 0.3 |
| Hospital where biopsy/RP performed | ||||||
| Regional/regional | Reference | |||||
| Regional/metropolitan | 2.3 | 1.7–3.1 | < 0.001 | 2.2 | 1.6–3.2 | < 0.001 |
| Metropolitan/regional | 2.3 | 0.7–7.4 | 0.1 | 4.8 | 0.8–29.7 | 0.08 |
| Metropolitan/metropolitan | 1.2 | 1.0–1.6 | 0.03 | 1.7 | 1.2–2.2 | < 0.001 |
| RP median annual surgeon volume | 1.005 | 1.002–1.008 | < 0.001 | |||
| Pathological T categories | ||||||
| pT2 | Reference | a) | ||||
| pT3 | 1.0 | 0.9–1.2 | 0.3 | |||
| Surgical margins | ||||||
| Absent | Reference | a) | ||||
| Present | 1.2 | 1.1–1.4 | < 0.001 | |||
| Extraperitoneal invasion | ||||||
| No | Reference | a) | ||||
| Yes | 1.03 | 0.8–1.2 | 0.7 | |||
CI, confidence interval; LRP, laparoscopic radical prostatectomy; OR, odds ratio; PSA, prostate-specific antigen; RP, radical prostatectomy; TRUS, transrectal ultrasound; TURP, transurethral resection of the prostate.
a)
Variables not entered in to the final model.
b)
Dependent variable was upgraded 0–4 in an ordered logistic model.