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BACKGROUND: Inflammatory processes are thought to contribute to the development and progression of prostate cancer (PCa). This study aimed to evaluate whether a novel Prostatic Inflammation Score (PIS), integrating Irani Grade (G) and Aggressiveness (A), could predict the risk of biochemical recurrence (BCR) following radical prostatectomy (RP). METHODS: Patients undergoing biopsy and RP between 2013 and 2023 were included. PIS was assessed on hematoxylin and eosin-stained biopsy cores: PIS 1 (G 0-1/A 0-1), PIS 2 (G 2-3/A 0-1), and PIS 3 (G 0-3/A 2-3). BCR, considered as two consecutive PSA readings of ≥ 0.2 ng/mL, was evaluated through multivariable Cox regression analysis. RESULTS: Among 679 patients (median follow-up: 36 months), 127 (18.7%) experienced BCR. Over a median follow-up of 36 months, 127 (18.7%) patients experienced BCR. BCR incidence at six years was highest in PIS 1 (30%) vs. PIS 2 (10%) and PIS 3 (9%) (p = 0.002). Compared to PIS 1, hazard ratios (HR) for BCR were 0.44 (95% CI: 0.27-0.74) for PIS 2 and 0.37 (95% CI: 0.15-0.91) for PIS 3. IRANI G scores inversely correlated with BCR risk (HR = 0.44, 95% CI: 0.27-0.74), while IRANI A scores (2-3) showed a nonsignificant trend (HR = 0.41, 95% CI: 0.17-1.02, p = 0.054). Gleason grade and pT stage were significantly associated with BCR, while margin status and pN stage were not. CONCLUSIONS: PIS 1 was found to be associated with BCR after RP. Should these findings be externally validated, PIS could represent a readily available inexpensive tool to predict BCR after RP.
Guzzi et al. (Thu,) studied this question.