Prognostic Impact of Different Gleason Patterns on Biopsy Within Grade Group 4 Prostate Cancer
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Prognostic Impact of Different Gleason Patterns on Biopsy Within Grade Group 4 Prostate Cancer. / Mori, Keiichiro; Sharma, Vidit; Comperat, Eva M; Sato, Shun; Laukhtina, Ekaterina; Schuettfort, Victor M; Pradere, Benjamin; Sari Motlagh, Reza; Mostafaei, Hadi; Quhal, Fahad; Kardoust Parizi, Mehdi; Abufaraj, Mohammad; Karakiewicz, Pierre I; Egawa, Shin; Tilki, Derya; Boorjian, Stephen A; Shariat, Shahrokh F.
in: ANN SURG ONCOL, Jahrgang 28, Nr. 13, 12.2021, S. 9179-9187.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Prognostic Impact of Different Gleason Patterns on Biopsy Within Grade Group 4 Prostate Cancer
AU - Mori, Keiichiro
AU - Sharma, Vidit
AU - Comperat, Eva M
AU - Sato, Shun
AU - Laukhtina, Ekaterina
AU - Schuettfort, Victor M
AU - Pradere, Benjamin
AU - Sari Motlagh, Reza
AU - Mostafaei, Hadi
AU - Quhal, Fahad
AU - Kardoust Parizi, Mehdi
AU - Abufaraj, Mohammad
AU - Karakiewicz, Pierre I
AU - Egawa, Shin
AU - Tilki, Derya
AU - Boorjian, Stephen A
AU - Shariat, Shahrokh F
N1 - © 2021. The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - BACKGROUND: Grade group (GG) 4 prostate cancer (PC) is considered a single entity; however, there are questions regarding prognostic heterogeneity. This study assessed the prognostic differences among various Gleason scores (GSs) classified as GG 4 PC on biopsy before radical prostatectomy (RP).METHODS: We conducted a multicenter retrospective study, and a total of 1791 patients (GS 3 + 5: 190; GS 4 + 4: 1557; and GS 5 + 3: 44) with biopsy GG 4 were included for analysis. Biochemical recurrence (BCR)-free survival, cancer-specific survival, and overall survival were analyzed using the Kaplan-Meier method and the log-rank test. Logistic regression analysis was performed to identify factors associated with high-risk surgical pathologic features. Cox regression models were used to analyze time-dependent oncologic endpoints.RESULTS: Over a median follow-up of 75 months, 750 patients (41.9%) experienced BCR, 146 (8.2%) died of any causes, and 57 (3.2%) died of PC. Biopsy GS 5 + 3 was associated with significantly higher rates of GS upgrading in RP specimens than GS 3 + 5 and GS 4 + 4. On multivariable analysis adjusted for clinicopathologic features, different GSs within GG 4 were significantly associated with BCR (p = 0.03) but not PC-specific or all-cause mortality. Study limitations include the lack of central pathological specimen evaluation.CONCLUSIONS: Patients with GG 4 at biopsy exhibited some limited biological and clinical heterogeneity. Specifically, GS 5 + 3 had an increased risk of GS upgrading. This can help individualize patients' counseling and encourage further study to refine biopsy specimen-based GG classification.
AB - BACKGROUND: Grade group (GG) 4 prostate cancer (PC) is considered a single entity; however, there are questions regarding prognostic heterogeneity. This study assessed the prognostic differences among various Gleason scores (GSs) classified as GG 4 PC on biopsy before radical prostatectomy (RP).METHODS: We conducted a multicenter retrospective study, and a total of 1791 patients (GS 3 + 5: 190; GS 4 + 4: 1557; and GS 5 + 3: 44) with biopsy GG 4 were included for analysis. Biochemical recurrence (BCR)-free survival, cancer-specific survival, and overall survival were analyzed using the Kaplan-Meier method and the log-rank test. Logistic regression analysis was performed to identify factors associated with high-risk surgical pathologic features. Cox regression models were used to analyze time-dependent oncologic endpoints.RESULTS: Over a median follow-up of 75 months, 750 patients (41.9%) experienced BCR, 146 (8.2%) died of any causes, and 57 (3.2%) died of PC. Biopsy GS 5 + 3 was associated with significantly higher rates of GS upgrading in RP specimens than GS 3 + 5 and GS 4 + 4. On multivariable analysis adjusted for clinicopathologic features, different GSs within GG 4 were significantly associated with BCR (p = 0.03) but not PC-specific or all-cause mortality. Study limitations include the lack of central pathological specimen evaluation.CONCLUSIONS: Patients with GG 4 at biopsy exhibited some limited biological and clinical heterogeneity. Specifically, GS 5 + 3 had an increased risk of GS upgrading. This can help individualize patients' counseling and encourage further study to refine biopsy specimen-based GG classification.
KW - Biopsy
KW - Humans
KW - Male
KW - Neoplasm Grading
KW - Prognosis
KW - Prostate-Specific Antigen
KW - Prostatectomy
KW - Prostatic Neoplasms/surgery
KW - Retrospective Studies
U2 - 10.1245/s10434-021-10257-x
DO - 10.1245/s10434-021-10257-x
M3 - SCORING: Journal article
C2 - 34117577
VL - 28
SP - 9179
EP - 9187
JO - ANN SURG ONCOL
JF - ANN SURG ONCOL
SN - 1068-9265
IS - 13
ER -
