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Table 1 Summary data for studies comparing outcomes between biopsy and prostatectomy included for this review

From: Old men with prostate cancer have higher risk of Gleason score upgrading and pathological upstaging after initial diagnosis: a systematic review and meta-analysis

Author (year ) Study characteristic a Patient characteristic
Study region (interval) Study size, n No. Gleason score change, n (%) No. Upstaging, n (%) Definition of Gleason score change (from bGS to pGS) Definition of upstaging Mean age, years Mean PSA, ng/mL Mean PV, mL bGS Clinical T-stage No. cores obtained, n
Audenet 2017 [14] France (2006–2013) 1791 1093(61.0) ≤ 6 to ≥ 7 NA NA NA ≤ 6 T1c–3b 10–14
Bullock 2019 [15] UK (2011–2016) 17598 4489(25.5) Any upgrading 63.2 10.06 NA > 7: 14% T1–4 NR
Dinh 2015 [16] USA (2010–2011) 10288 4467(43.4) 992(9.6) ≤ 6 to ≥ 7 cT1–2N0 to pT3a–4N0–1 59.5 5.2 NA ≤ 6 T1c–2a 12
Dinizo 2018 [6] USA (2003–2014) 2256 784(34.8) 163(7.2) ≤ 6 to ≥ 7 cT1–2 to pT3a–4 NA NA NA ≤ 6 T1–2a ≥ 12
Epstein 2012 [17] USA (2002–2010) 5071 1841(36.3) ≤ 6 to ≥ 7 NA NA NA ≤ 6 T1–2a NR
Ferro 2019 [18] Italy (2006–2013) 260 166(63.8) ≤ 6 to ≥ 7 62.2 5.8 51.9 > 3 + 4: 13% T1c–2a Median 10, Range 6–40
Gondo 2015 [9] USA (2005–2013) 1317 115(8.7) 3 + 4 to ≤ 6 NA NA NA 3 + 4 T1c–4 ≥ 12
Jalloh 2015 [19] USA (1990–2012) 4231 1123(26.5) 499(11.8) ≤ 6 to ≥ 7 cT1–2N0 to pT3a–4N0–1 59.9 NA NA ≤ 6 T1–2 Mean 9.15
Jeon 2017 [10] USA and Korea (2006–2015) 854 484(56.7) 88(10.3) ≤ 6 to ≥ 7 cT1–2 to pT3a–4 NA NA NA ≤ 6 T1c–2a NR
Leeman 2019 [11] Germany (1992–2017) 3571 115(3.2) 245(6.9) ≤ 6 to ≥ 7 cT1–2 to pT3a–4 NA NA NA ≤ 6 T1c–2 Median 9
Luzzago 2018 [20] Italy (2012–2016) 383 134(35.0) bGS≤ 6, cT1–2N0 to pGS ≥ 7 and/or pT3a–4N0–1 NA NA NA ≤ 6 T1c–2a ≥ 12
Lyon 2016 [21] USA (1999–2015) 1256 647(51.5) ≤ 6 to ≥ 7 NA NA NA ≤ 6 T1–4 ≥ 6
Kim 2013 [22] Korea (2005–2011) 451 194(43.0) ≤ 6 to ≥ 7 64 8.79 38.1 ≤ 6 T1–2 Mean 11.5, Range 2–27
Kwon 2016 [23] USA (2006–2015) 217 58(26.7) ≤ 6 to ≥ 7 NA NA NA ≤ 6 T1–2a NR
Magheli 2010 [24] Germany (1999–2004) 610 308(50.5) ≤ 6 to ≥ 7 NA NA NA ≤ 6 T1–2 NR
Martin 2017 [25] USA (2005–2008) 136 19(14.0) ≤ 7 to ≥ 8 NA NA NA ≤ 7 T1c–2 ≥ 10
Mizuno 2016 [26] Japan (2005–2011) 284 154 (54.2) bGS ≤ 6, cT1–2 to pGS ≥ 7 and/or pT3a–4 NA NA NA ≤ 6 T1c–2a NR
Morlacco 2016 [5] USA (2006–2014) 1190 156(13.1) 205(17.2) 3 + 4 to ≥ 4 + 3 cT1–2 to pT3a–4 NA NA NA 3 + 4 T1c–2a Median 12, IQR 12–14
201(16.9) 3 + 4 to ≤ 6
295 (24.8) bGS = 3 + 4, cT1–2N0 to pGS ≥ 4 + 3 and/or pT3a–4N0–1
Oh 2012 [27] Korea (2003–2010) 505 253(50.1) ≤ 6 to ≥ 7 65.2 7.79 39.5 ≤ 6 T1c–2a ≥ 12
Pietzak 2014 [28] USA (1998–2008) 400 - 49(12.3) cT1-2 to pT3a-4 NA NA NA ≤ 6 T1c–2a ≥ 10
Shoag 2020 [29] USA (2010–2015) 11025 2255(45.2) Any downgrading NA NA NA 6–10 T1–3 NR
Weiner 2015 [30] USA (2010–2011) 17943 8113(45.2) bGS ≤ 6, cT1-2N0 to pGS ≥ 7 and/or pT3a–4N0–1 NA NA NA ≤ 6 T1–2a NR
Wong 2012 [31] Canada, Australia and UK (2003–2010) 644 333 bGS ≤ 6, cT1–2 to pGS ≥ 8 and/or pT3a–4 NA NA NA ≤ 6 T1–2a 8–12
Zanaty 2018 [12] Canada (2006–2014) 237 134(56.5) ≤ 6 to ≥ 7 58.6 38.4 5.03 NR T1c–2a NR
  1. PSA prostate-specific antigen, PV prostate volume, bGS biopsy Gleason score, pGS prostatectomy Gleason score, NA not available, IQR interquartile range
  2. aAll studies were case-control designs