Differential prognostic impact of different Gleason patterns in grade group 4 in radical prostatectomy specimens
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Differential prognostic impact of different Gleason patterns in grade group 4 in radical prostatectomy specimens. / Mori, Keiichiro; Sharma, Vidit; Comperat, Eva M; Sato, Shun; Laukhtina, Ekaterina; Schuettfort, Victor M; Pradere, Benjamin; Parizi, Mehdi Kardoust; Karakiewicz, Pierre I; Egawa, Shin; Tilki, Derya; Boorjian, Stephen A; Shariat, Shahrokh F.
in: EJSO-EUR J SURG ONC, Jahrgang 47, Nr. 5, 05.2021, S. 1172-1178.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Differential prognostic impact of different Gleason patterns in grade group 4 in radical prostatectomy specimens
AU - Mori, Keiichiro
AU - Sharma, Vidit
AU - Comperat, Eva M
AU - Sato, Shun
AU - Laukhtina, Ekaterina
AU - Schuettfort, Victor M
AU - Pradere, Benjamin
AU - Parizi, Mehdi Kardoust
AU - Karakiewicz, Pierre I
AU - Egawa, Shin
AU - Tilki, Derya
AU - Boorjian, Stephen A
AU - Shariat, Shahrokh F
N1 - Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - INTRODUCTION: There are questions regarding whether grade group (GG) 4 prostate cancer (PC) is heterogeneous in terms of prognosis. We assessed prognostic differences in PC patients within GG 4 treated with radical prostatectomy (RP).MATERIAL AND METHODS: Biochemical recurrence (BCR)-free, cancer-specific, and overall survival were analyzed in 787 PC patients with GG 4 based on RP pathology (Gleason score (GS) 3 + 5: 189, GS 4 + 4: 500, and GS 5 + 3: 98). Logistic regression analysis was performed to assess factors predictive of high-risk surgical pathological features. Cox regression models were used to evaluate potential prognostic factors of survival.RESULTS: Within a median follow-up of 86 months, 378 patients (48.0%) experienced BCR and 96 patients (12.2%) died, 42 of whom (5.3%) died of PC. GS 5 + 3 was significantly associated with worse BCR-free and cancer-specific survival, as well as higher positive surgical margin, lymph node metastasis, extraprostatic extension, and non-organ-confined disease rates, than GS 3 + 5 and higher positive surgical margin, lymph node metastasis, extraprostatic extension, and non-organ-confined disease rates than GS 4 + 4 (P < 0.05). GS 4 + 4 was significantly associated with worse BCR-free survival and higher extraprostatic extension, and non-organ-confined disease rates than GS 3 + 5 (P < 0.05). Inclusion of the different Gleason patterns improved the discrimination of a model for prediction of all survival outcomes compared to standard prognosticators.CONCLUSIONS: There is considerable heterogeneity within GG 4 in terms of oncological and surgical pathological outcomes. Primary and secondary Gleason patterns should be considered to stratify high-risk PC patients after RP.
AB - INTRODUCTION: There are questions regarding whether grade group (GG) 4 prostate cancer (PC) is heterogeneous in terms of prognosis. We assessed prognostic differences in PC patients within GG 4 treated with radical prostatectomy (RP).MATERIAL AND METHODS: Biochemical recurrence (BCR)-free, cancer-specific, and overall survival were analyzed in 787 PC patients with GG 4 based on RP pathology (Gleason score (GS) 3 + 5: 189, GS 4 + 4: 500, and GS 5 + 3: 98). Logistic regression analysis was performed to assess factors predictive of high-risk surgical pathological features. Cox regression models were used to evaluate potential prognostic factors of survival.RESULTS: Within a median follow-up of 86 months, 378 patients (48.0%) experienced BCR and 96 patients (12.2%) died, 42 of whom (5.3%) died of PC. GS 5 + 3 was significantly associated with worse BCR-free and cancer-specific survival, as well as higher positive surgical margin, lymph node metastasis, extraprostatic extension, and non-organ-confined disease rates, than GS 3 + 5 and higher positive surgical margin, lymph node metastasis, extraprostatic extension, and non-organ-confined disease rates than GS 4 + 4 (P < 0.05). GS 4 + 4 was significantly associated with worse BCR-free survival and higher extraprostatic extension, and non-organ-confined disease rates than GS 3 + 5 (P < 0.05). Inclusion of the different Gleason patterns improved the discrimination of a model for prediction of all survival outcomes compared to standard prognosticators.CONCLUSIONS: There is considerable heterogeneity within GG 4 in terms of oncological and surgical pathological outcomes. Primary and secondary Gleason patterns should be considered to stratify high-risk PC patients after RP.
U2 - 10.1016/j.ejso.2020.12.014
DO - 10.1016/j.ejso.2020.12.014
M3 - SCORING: Journal article
C2 - 33371950
VL - 47
SP - 1172
EP - 1178
JO - EJSO-EUR J SURG ONC
JF - EJSO-EUR J SURG ONC
SN - 0748-7983
IS - 5
ER -
