Clinical outcomes and genomic alterations in Gleason score 10 prostate cancer: retrospective analysis in The Cancer Genome Atlas database

Gleason score (GS) 10 prostate cancer (PrC) is a highly aggressive localized disease. The clinical outcomes and molecular underpinnings of GS 10 are unclear. A retrospective analysis of The Genome Atlas database compared clinical outcomes and genomic alterations of GS 10 PrC with those of GS 8-9 PrC. Of 192 patients, 13 (6.8%) had GS 10 PrC. The median duration of follow-up was 37.87 months. The time to biochemical recurrence was significantly shorter in GS 10 compared to GS 8-9 PrC (aHR 2.67; p=0.018). Multiple genes showed higher alteration frequencies in GS 10 compared to GS 8-9, and high expression of RAD54L, MAST2, and CCHCR1 correlated with shorter disease-free survival. The authors conclude that these results highlight the need for biomarker-driven therapeutic strategies for GS 10 PrC.