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Clinical Utility of Quantitative Gleason Grading in Prostate Biopsies and Prostatectomy Specimens

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Clinical Utility of Quantitative Gleason Grading in Prostate Biopsies and Prostatectomy Specimens. / Sauter, Guido; Steurer, Stefan; Clauditz, Till Sebastian; Krech, Till; Wittmer, Corinna; Lutz, Florian; Lennartz, Maximilian; Janssen, Tim; Hakimi, Nayira; Simon, Ronald; von Petersdorff-Campen, Mareike; Jacobsen, Frank; Loga, Katharina; Wilczak, Waldemar; Minner, Sarah; Tsourlakis, Maria Christina; Chirico, Viktoria; Haese, Alexander; Heinzer, Hans; Beyer, Burkhard; Graefen, Markus; Michl, Uwe; Salomon, Georg; Steuber, Thomas; Budäus, Lars Henrik; Hekeler, Elena; Malsy-Mink, Julia; Kutzera, Sven; Fraune, Christoph; Göbel, Cosima; Huland, Hartwig; Schlomm, Thorsten.

in: EUR UROL, Jahrgang 69, Nr. 4, 01.04.2016, S. 592-8.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Sauter, G, Steurer, S, Clauditz, TS, Krech, T, Wittmer, C, Lutz, F, Lennartz, M, Janssen, T, Hakimi, N, Simon, R, von Petersdorff-Campen, M, Jacobsen, F, Loga, K, Wilczak, W, Minner, S, Tsourlakis, MC, Chirico, V, Haese, A, Heinzer, H, Beyer, B, Graefen, M, Michl, U, Salomon, G, Steuber, T, Budäus, LH, Hekeler, E, Malsy-Mink, J, Kutzera, S, Fraune, C, Göbel, C, Huland, H & Schlomm, T 2016, 'Clinical Utility of Quantitative Gleason Grading in Prostate Biopsies and Prostatectomy Specimens', EUR UROL, Jg. 69, Nr. 4, S. 592-8. https://doi.org/10.1016/j.eururo.2015.10.029

APA

Sauter, G., Steurer, S., Clauditz, T. S., Krech, T., Wittmer, C., Lutz, F., Lennartz, M., Janssen, T., Hakimi, N., Simon, R., von Petersdorff-Campen, M., Jacobsen, F., Loga, K., Wilczak, W., Minner, S., Tsourlakis, M. C., Chirico, V., Haese, A., Heinzer, H., ... Schlomm, T. (2016). Clinical Utility of Quantitative Gleason Grading in Prostate Biopsies and Prostatectomy Specimens. EUR UROL, 69(4), 592-8. https://doi.org/10.1016/j.eururo.2015.10.029

Vancouver

Sauter G, Steurer S, Clauditz TS, Krech T, Wittmer C, Lutz F et al. Clinical Utility of Quantitative Gleason Grading in Prostate Biopsies and Prostatectomy Specimens. EUR UROL. 2016 Apr 1;69(4):592-8. https://doi.org/10.1016/j.eururo.2015.10.029

Bibtex

@article{b5f05ad9f01c482993fff2e120c0c082,
title = "Clinical Utility of Quantitative Gleason Grading in Prostate Biopsies and Prostatectomy Specimens",
abstract = "BACKGROUND: Gleason grading is the strongest prognostic parameter in prostate cancer. Gleason grading is categorized as Gleason ≤6, 3+4, 4+3, 8, and 9-10, but there is variability within these subgroups. For example, Gleason 4 components may range from 5-45% in a Gleason 3+4=7 cancer.OBJECTIVE: To assess the clinical relevance of the fractions of Gleason patterns.DESIGN, SETTING, AND PARTICIPANTS: Prostatectomy specimens from 12823 consecutive patients and of 2971 matched preoperative biopsies for which clinical data with an annual follow-up between 2005 and 2014 were available from the Martini-Klinik database.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: To evaluate the utility of quantitative grading, the fraction of Gleason 3, 4, and 5 patterns seen in biopsies and prostatectomies were recorded. Gleason grade fractions were compared with prostatectomy findings and prostate-specific antigen recurrence.RESULTS AND LIMITATIONS: Our data suggest a striking utility of quantitative Gleason grading. In prostatectomy specimens, there was a continuous increase of the risk of prostate-specific antigen recurrence with increasing percentage of Gleason 4 fractions with remarkably small differences in outcome at clinically important thresholds (0% vs 5%; 40% vs 60% Gleason 4), distinguishing traditionally established prognostic groups. Also, in biopsies, the quantitative Gleason scoring identified various intermediate risk groups with respect to Gleason findings in corresponding prostatectomies. Quantitative grading may also reduce the clinical impact of interobserver variability because borderline findings such as tumors with 5%, 40%, or 60% Gleason 4 fractions and very small Gleason 5 fractions (with pivotal impact on the Gleason score) are disclaimed.CONCLUSIONS: Quantitative Gleason pattern data should routinely be provided in addition to Gleason score categories, both in biopsies and in prostatectomy specimens.PATIENT SUMMARY: Gleason score is the most important prognostic parameter in prostate cancer, but prone to interobserver variation. The results of our study show that morphological aspects that define the Gleason grade in prostate cancer represent a continuum. Quantitation of Gleason patterns provides clinically relevant information beyond the traditional Gleason grading categories ≤3+3, 3+4, 4+3, 8, 9-10. Quantitative Gleason scoring can help to minimize variations between different pathologists and substantially aid in optimized therapy decision-making.",
author = "Guido Sauter and Stefan Steurer and Clauditz, {Till Sebastian} and Till Krech and Corinna Wittmer and Florian Lutz and Maximilian Lennartz and Tim Janssen and Nayira Hakimi and Ronald Simon and {von Petersdorff-Campen}, Mareike and Frank Jacobsen and Katharina Loga and Waldemar Wilczak and Sarah Minner and Tsourlakis, {Maria Christina} and Viktoria Chirico and Alexander Haese and Hans Heinzer and Burkhard Beyer and Markus Graefen and Uwe Michl and Georg Salomon and Thomas Steuber and Bud{\"a}us, {Lars Henrik} and Elena Hekeler and Julia Malsy-Mink and Sven Kutzera and Christoph Fraune and Cosima G{\"o}bel and Hartwig Huland and Thorsten Schlomm",
note = "Copyright {\textcopyright} 2015. Published by Elsevier B.V.",
year = "2016",
month = apr,
day = "1",
doi = "10.1016/j.eururo.2015.10.029",
language = "English",
volume = "69",
pages = "592--8",
journal = "EUR UROL",
issn = "0302-2838",
publisher = "Elsevier",
number = "4",

}

RIS

TY - JOUR

T1 - Clinical Utility of Quantitative Gleason Grading in Prostate Biopsies and Prostatectomy Specimens

AU - Sauter, Guido

AU - Steurer, Stefan

AU - Clauditz, Till Sebastian

AU - Krech, Till

AU - Wittmer, Corinna

AU - Lutz, Florian

AU - Lennartz, Maximilian

AU - Janssen, Tim

AU - Hakimi, Nayira

AU - Simon, Ronald

AU - von Petersdorff-Campen, Mareike

AU - Jacobsen, Frank

AU - Loga, Katharina

AU - Wilczak, Waldemar

AU - Minner, Sarah

AU - Tsourlakis, Maria Christina

AU - Chirico, Viktoria

AU - Haese, Alexander

AU - Heinzer, Hans

AU - Beyer, Burkhard

AU - Graefen, Markus

AU - Michl, Uwe

AU - Salomon, Georg

AU - Steuber, Thomas

AU - Budäus, Lars Henrik

AU - Hekeler, Elena

AU - Malsy-Mink, Julia

AU - Kutzera, Sven

AU - Fraune, Christoph

AU - Göbel, Cosima

AU - Huland, Hartwig

AU - Schlomm, Thorsten

N1 - Copyright © 2015. Published by Elsevier B.V.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - BACKGROUND: Gleason grading is the strongest prognostic parameter in prostate cancer. Gleason grading is categorized as Gleason ≤6, 3+4, 4+3, 8, and 9-10, but there is variability within these subgroups. For example, Gleason 4 components may range from 5-45% in a Gleason 3+4=7 cancer.OBJECTIVE: To assess the clinical relevance of the fractions of Gleason patterns.DESIGN, SETTING, AND PARTICIPANTS: Prostatectomy specimens from 12823 consecutive patients and of 2971 matched preoperative biopsies for which clinical data with an annual follow-up between 2005 and 2014 were available from the Martini-Klinik database.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: To evaluate the utility of quantitative grading, the fraction of Gleason 3, 4, and 5 patterns seen in biopsies and prostatectomies were recorded. Gleason grade fractions were compared with prostatectomy findings and prostate-specific antigen recurrence.RESULTS AND LIMITATIONS: Our data suggest a striking utility of quantitative Gleason grading. In prostatectomy specimens, there was a continuous increase of the risk of prostate-specific antigen recurrence with increasing percentage of Gleason 4 fractions with remarkably small differences in outcome at clinically important thresholds (0% vs 5%; 40% vs 60% Gleason 4), distinguishing traditionally established prognostic groups. Also, in biopsies, the quantitative Gleason scoring identified various intermediate risk groups with respect to Gleason findings in corresponding prostatectomies. Quantitative grading may also reduce the clinical impact of interobserver variability because borderline findings such as tumors with 5%, 40%, or 60% Gleason 4 fractions and very small Gleason 5 fractions (with pivotal impact on the Gleason score) are disclaimed.CONCLUSIONS: Quantitative Gleason pattern data should routinely be provided in addition to Gleason score categories, both in biopsies and in prostatectomy specimens.PATIENT SUMMARY: Gleason score is the most important prognostic parameter in prostate cancer, but prone to interobserver variation. The results of our study show that morphological aspects that define the Gleason grade in prostate cancer represent a continuum. Quantitation of Gleason patterns provides clinically relevant information beyond the traditional Gleason grading categories ≤3+3, 3+4, 4+3, 8, 9-10. Quantitative Gleason scoring can help to minimize variations between different pathologists and substantially aid in optimized therapy decision-making.

AB - BACKGROUND: Gleason grading is the strongest prognostic parameter in prostate cancer. Gleason grading is categorized as Gleason ≤6, 3+4, 4+3, 8, and 9-10, but there is variability within these subgroups. For example, Gleason 4 components may range from 5-45% in a Gleason 3+4=7 cancer.OBJECTIVE: To assess the clinical relevance of the fractions of Gleason patterns.DESIGN, SETTING, AND PARTICIPANTS: Prostatectomy specimens from 12823 consecutive patients and of 2971 matched preoperative biopsies for which clinical data with an annual follow-up between 2005 and 2014 were available from the Martini-Klinik database.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: To evaluate the utility of quantitative grading, the fraction of Gleason 3, 4, and 5 patterns seen in biopsies and prostatectomies were recorded. Gleason grade fractions were compared with prostatectomy findings and prostate-specific antigen recurrence.RESULTS AND LIMITATIONS: Our data suggest a striking utility of quantitative Gleason grading. In prostatectomy specimens, there was a continuous increase of the risk of prostate-specific antigen recurrence with increasing percentage of Gleason 4 fractions with remarkably small differences in outcome at clinically important thresholds (0% vs 5%; 40% vs 60% Gleason 4), distinguishing traditionally established prognostic groups. Also, in biopsies, the quantitative Gleason scoring identified various intermediate risk groups with respect to Gleason findings in corresponding prostatectomies. Quantitative grading may also reduce the clinical impact of interobserver variability because borderline findings such as tumors with 5%, 40%, or 60% Gleason 4 fractions and very small Gleason 5 fractions (with pivotal impact on the Gleason score) are disclaimed.CONCLUSIONS: Quantitative Gleason pattern data should routinely be provided in addition to Gleason score categories, both in biopsies and in prostatectomy specimens.PATIENT SUMMARY: Gleason score is the most important prognostic parameter in prostate cancer, but prone to interobserver variation. The results of our study show that morphological aspects that define the Gleason grade in prostate cancer represent a continuum. Quantitation of Gleason patterns provides clinically relevant information beyond the traditional Gleason grading categories ≤3+3, 3+4, 4+3, 8, 9-10. Quantitative Gleason scoring can help to minimize variations between different pathologists and substantially aid in optimized therapy decision-making.

U2 - 10.1016/j.eururo.2015.10.029

DO - 10.1016/j.eururo.2015.10.029

M3 - SCORING: Journal article

C2 - 26542947

VL - 69

SP - 592

EP - 598

JO - EUR UROL

JF - EUR UROL

SN - 0302-2838

IS - 4

ER -