%0 Journal Article
%T The influence of Gleason score ≤ 6 histology on the outcome of high-risk localized prostate cancer after modern radiotherapy.
%A Yamazaki H
%A Suzuki G
%A Masui K
%A Aibe N
%A Kimoto T
%A Yamada K
%A Okihara K
%A Hongo F
%A Okumi M
%A Shiraishi T
%A Fujihara A
%A Yoshida K
%A Nakamura S
%A Kato T
%A Hashimoto Y
%A Okabe H
%J Sci Rep
%V 14
%N 1
%D 2024 04 5
%M 38580670
%F 4.996
%R 10.1038/s41598-024-55457-z
%X We aimed to retrospectively review outcomes in patients with high-risk prostate cancer and a Gleason score ≤ 6 following modern radiotherapy. We analyzed the outcomes of 1374 patients who had undergone modern radiotherapy, comprising a high-risk low grade [HRLG] group (Gleason score ≤ 6; n = 94) and a high-risk high grade [HRHG] group (Gleason score ≥ 7, n = 1125). We included 955 patients who received brachytherapy with or without external beam radio-therapy (EBRT) and 264 who received modern EBRT (intensity-modulated radiotherapy [IMRT] or stereotactic body radiotherapy [SBRT]). At a median follow-up of 60 (2-177) months, actuarial 5-year biochemical failure-free survival rates were 97.8 and 91.8% (p = 0.017), respectively. The frequency of clinical failure in the HRLG group was less than that in the HRHG group (0% vs 5.4%, p = 0.012). The HRLG group had a better 5-year distant metastasis-free survival than the HRHG group (100% vs 96.0%, p = 0.035). As the HRLG group exhibited no clinical failure and better outcomes than the HRHG group, the HRLG group might potentially be classified as a lower-risk group.