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Grade and stage misclassification in intermediate unfavorable-risk prostate cancer radiotherapy candidates

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Grade and stage misclassification in intermediate unfavorable-risk prostate cancer radiotherapy candidates. / Sorce, Gabriele; Flammia, Rocco Simone; Hoeh, Benedikt; Chierigo, Francesco; Hohenhorst, Lukas; Panunzio, Andrea; Stabile, Armando; Gandaglia, Giorgio; Tian, Zhe; Tilki, Derya; Terrone, Carlo; Gallucci, Michele; Chun, Felix K H; Antonelli, Alessandro; Saad, Fred; Shariat, Shahrokh F; Montorsi, Francesco; Briganti, Alberto; Karakiewicz, Pierre I.

In: PROSTATE, Vol. 82, No. 10, 06.2022, p. 1040-1050.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Sorce, G, Flammia, RS, Hoeh, B, Chierigo, F, Hohenhorst, L, Panunzio, A, Stabile, A, Gandaglia, G, Tian, Z, Tilki, D, Terrone, C, Gallucci, M, Chun, FKH, Antonelli, A, Saad, F, Shariat, SF, Montorsi, F, Briganti, A & Karakiewicz, PI 2022, 'Grade and stage misclassification in intermediate unfavorable-risk prostate cancer radiotherapy candidates', PROSTATE, vol. 82, no. 10, pp. 1040-1050. https://doi.org/10.1002/pros.24349

APA

Sorce, G., Flammia, R. S., Hoeh, B., Chierigo, F., Hohenhorst, L., Panunzio, A., Stabile, A., Gandaglia, G., Tian, Z., Tilki, D., Terrone, C., Gallucci, M., Chun, F. K. H., Antonelli, A., Saad, F., Shariat, S. F., Montorsi, F., Briganti, A., & Karakiewicz, P. I. (2022). Grade and stage misclassification in intermediate unfavorable-risk prostate cancer radiotherapy candidates. PROSTATE, 82(10), 1040-1050. https://doi.org/10.1002/pros.24349

Vancouver

Sorce G, Flammia RS, Hoeh B, Chierigo F, Hohenhorst L, Panunzio A et al. Grade and stage misclassification in intermediate unfavorable-risk prostate cancer radiotherapy candidates. PROSTATE. 2022 Jun;82(10):1040-1050. https://doi.org/10.1002/pros.24349

Bibtex

@article{7fb89a49ca3b46e3b422780c39aeee57,
title = "Grade and stage misclassification in intermediate unfavorable-risk prostate cancer radiotherapy candidates",
abstract = "BACKGROUND: We tested for upgrading (Gleason grade group [GGG] ≥ 4) and/or upstaging to non-organ-confined stage ([NOC] ≥ pT3/pN1) in intermediate unfavorable-risk (IU) prostate cancer (PCa) patients treated with radical prostatectomy, since both change the considerations for dose and/or type of radiotherapy (RT) and duration of androgen deprivation therapy (ADT).METHODS: We relied on Surveillance, Epidemiology, and End Results (2010-2015). Proportions of (a) upgrading, (b) upstaging, or (c) upgrading and/or upstaging were tabulated and tested in multivariable logistic regression models.RESULTS: We identified 7269 IU PCa patients. Upgrading was recorded in 479 (6.6%) and upstaging in 2398 (33.0%), for a total of 2616 (36.0%) upgraded and/or upstaged patients, who no longer fulfilled the IU grade and stage definition. Prostate-specific antigen, clinical stage, biopsy GGG, and percentage of positive cores, neither individually nor in multivariable logistic regression models, discriminated between upgraded and/or upstaged patients versus others.CONCLUSIONS: IU PCa patients showed very high (36%) upgrading and/or upstaging proportion. Interestingly, the overwhelming majority of those were upstaged to NOC. Conversely, very few were upgraded to GGG ≥ 4. In consequence, more than one-third of IU PCa patients treated with RT may be exposed to suboptimal dose and/or type of RT and to insufficient duration of ADT, since their true grade and stage corresponded to high-risk PCa definition, instead of IU PCa. Data about magnetic resonance imaging were not available but may potentially help with better stage discrimination.",
keywords = "Androgen Antagonists/therapeutic use, Humans, Male, Neoplasm Grading, Neoplasm Staging, Prostate-Specific Antigen, Prostatectomy/methods, Prostatic Neoplasms/pathology",
author = "Gabriele Sorce and Flammia, {Rocco Simone} and Benedikt Hoeh and Francesco Chierigo and Lukas Hohenhorst and Andrea Panunzio and Armando Stabile and Giorgio Gandaglia and Zhe Tian and Derya Tilki and Carlo Terrone and Michele Gallucci and Chun, {Felix K H} and Alessandro Antonelli and Fred Saad and Shariat, {Shahrokh F} and Francesco Montorsi and Alberto Briganti and Karakiewicz, {Pierre I}",
note = "{\textcopyright} 2022 The Authors. The Prostate published by Wiley Periodicals LLC.",
year = "2022",
month = jun,
doi = "10.1002/pros.24349",
language = "English",
volume = "82",
pages = "1040--1050",
journal = "PROSTATE",
issn = "0270-4137",
publisher = "Wiley-Liss Inc.",
number = "10",

}

RIS

TY - JOUR

T1 - Grade and stage misclassification in intermediate unfavorable-risk prostate cancer radiotherapy candidates

AU - Sorce, Gabriele

AU - Flammia, Rocco Simone

AU - Hoeh, Benedikt

AU - Chierigo, Francesco

AU - Hohenhorst, Lukas

AU - Panunzio, Andrea

AU - Stabile, Armando

AU - Gandaglia, Giorgio

AU - Tian, Zhe

AU - Tilki, Derya

AU - Terrone, Carlo

AU - Gallucci, Michele

AU - Chun, Felix K H

AU - Antonelli, Alessandro

AU - Saad, Fred

AU - Shariat, Shahrokh F

AU - Montorsi, Francesco

AU - Briganti, Alberto

AU - Karakiewicz, Pierre I

N1 - © 2022 The Authors. The Prostate published by Wiley Periodicals LLC.

PY - 2022/6

Y1 - 2022/6

N2 - BACKGROUND: We tested for upgrading (Gleason grade group [GGG] ≥ 4) and/or upstaging to non-organ-confined stage ([NOC] ≥ pT3/pN1) in intermediate unfavorable-risk (IU) prostate cancer (PCa) patients treated with radical prostatectomy, since both change the considerations for dose and/or type of radiotherapy (RT) and duration of androgen deprivation therapy (ADT).METHODS: We relied on Surveillance, Epidemiology, and End Results (2010-2015). Proportions of (a) upgrading, (b) upstaging, or (c) upgrading and/or upstaging were tabulated and tested in multivariable logistic regression models.RESULTS: We identified 7269 IU PCa patients. Upgrading was recorded in 479 (6.6%) and upstaging in 2398 (33.0%), for a total of 2616 (36.0%) upgraded and/or upstaged patients, who no longer fulfilled the IU grade and stage definition. Prostate-specific antigen, clinical stage, biopsy GGG, and percentage of positive cores, neither individually nor in multivariable logistic regression models, discriminated between upgraded and/or upstaged patients versus others.CONCLUSIONS: IU PCa patients showed very high (36%) upgrading and/or upstaging proportion. Interestingly, the overwhelming majority of those were upstaged to NOC. Conversely, very few were upgraded to GGG ≥ 4. In consequence, more than one-third of IU PCa patients treated with RT may be exposed to suboptimal dose and/or type of RT and to insufficient duration of ADT, since their true grade and stage corresponded to high-risk PCa definition, instead of IU PCa. Data about magnetic resonance imaging were not available but may potentially help with better stage discrimination.

AB - BACKGROUND: We tested for upgrading (Gleason grade group [GGG] ≥ 4) and/or upstaging to non-organ-confined stage ([NOC] ≥ pT3/pN1) in intermediate unfavorable-risk (IU) prostate cancer (PCa) patients treated with radical prostatectomy, since both change the considerations for dose and/or type of radiotherapy (RT) and duration of androgen deprivation therapy (ADT).METHODS: We relied on Surveillance, Epidemiology, and End Results (2010-2015). Proportions of (a) upgrading, (b) upstaging, or (c) upgrading and/or upstaging were tabulated and tested in multivariable logistic regression models.RESULTS: We identified 7269 IU PCa patients. Upgrading was recorded in 479 (6.6%) and upstaging in 2398 (33.0%), for a total of 2616 (36.0%) upgraded and/or upstaged patients, who no longer fulfilled the IU grade and stage definition. Prostate-specific antigen, clinical stage, biopsy GGG, and percentage of positive cores, neither individually nor in multivariable logistic regression models, discriminated between upgraded and/or upstaged patients versus others.CONCLUSIONS: IU PCa patients showed very high (36%) upgrading and/or upstaging proportion. Interestingly, the overwhelming majority of those were upstaged to NOC. Conversely, very few were upgraded to GGG ≥ 4. In consequence, more than one-third of IU PCa patients treated with RT may be exposed to suboptimal dose and/or type of RT and to insufficient duration of ADT, since their true grade and stage corresponded to high-risk PCa definition, instead of IU PCa. Data about magnetic resonance imaging were not available but may potentially help with better stage discrimination.

KW - Androgen Antagonists/therapeutic use

KW - Humans

KW - Male

KW - Neoplasm Grading

KW - Neoplasm Staging

KW - Prostate-Specific Antigen

KW - Prostatectomy/methods

KW - Prostatic Neoplasms/pathology

U2 - 10.1002/pros.24349

DO - 10.1002/pros.24349

M3 - SCORING: Journal article

C2 - 35365851

VL - 82

SP - 1040

EP - 1050

JO - PROSTATE

JF - PROSTATE

SN - 0270-4137

IS - 10

ER -