Clinical Usefulness of Total Length of Gleason Pattern 4 on Biopsy in Men with Grade Group 2 Prostate Cancer

Dean, Lucas W.; Assel, Melissa; Sjoberg, Daniel D.; Al‐Ahmadie, Hikmat; Chen, Ying-Bei; Gopalan, Anuradha; Sirintrapun, S. Joseph; Tickoo, Satish K.; Eastham, James A.; Scardino, Peter T.; Reuter, Victor E.; Ehdaie, Behfar; Fine, Samson W.

doi:10.1016/j.juro.2018.07.062

Cited by 37 publications

(37 citation statements)

References 19 publications

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“…The overall percentage of Gleason grade 4 on both radical prostatectomy and biopsy samples has been shown to be an independent predictor of adverse pathology at RP (174)(175)(176)(177), BCR (166,174,(176)(177)(178) and prostate cancer death among men with GG2 and/or GG3 (179). The overall percentage of Gleason grade 4 has been shown to outperform the maximum percentage of Gleason pattern 4 (174,180).…”

Section: The Percentage Of Gleason Patternmentioning

confidence: 98%

Predicting Prostate Cancer Death with Different Pretreatment Risk Stratification Tools: A Head-to-head Comparison in a Nationwide Cohort Study

et al. 2020

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Section: The Percentage Of Gleason Patternmentioning

confidence: 98%

Predicting Prostate Cancer Death with Different Pretreatment Risk Stratification Tools: A Head-to-head Comparison in a Nationwide Cohort Study

et al. 2020

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“…[5][6][7] However, a number of studies have shown that further quantification of pattern 4 has clinical significance. [8][9][10][11][12][13] For instance, biopsy specimens with GS 3+4 = 7 in which the greatest amount of pattern 4 was < 5% of the tumor volume in any one core had similar prostatectomy findings and biochemical recurrencefree survival to GS 3+3 = 6 cases in a recent study. 7 If other clinical variables are favorable, some GS 3+4 = 7 (GG2) patients with limited amounts of Gleason pattern 4 may qualify for active surveillance.…”

Section: Percentage Of High-grade Gleason Patternsmentioning

confidence: 99%

The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma

Leenders¹,

Kwast

Grignon

et al. 2020

American Journal of Surgical Pathology

376

311

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Five years after the last prostatic carcinoma grading consensus conference of the International Society of Urological Pathology (ISUP), accrual of new data and modification of clinical practice require an update of current pathologic grading guidelines. This manuscript summarizes the proceedings of the ISUP consensus meeting for grading of prostatic carcinoma held in September 2019, in Nice, France. Topics brought to consensus included the following: (1) approaches to reporting of Gleason patterns 4 and 5 quantities, and minor/tertiary patterns, (2) an agreement to report the presence of invasive cribriform carcinoma, (3) an agreement to incorporate intraductal carcinoma into grading, and (4) individual versus aggregate grading of systematic and multiparametric magnetic resonance imaging-targeted biopsies. Finally, developments in the field of artificial intelligence in the grading of prostatic carcinoma and future research perspectives were discussed.

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“…Moreover, the pathologists reviewed the deficiencies of the pathological report of 213 patients included in our study and confirmed that there was no problem. Adverse pathology (AP) was defined as GS ≥8, extracapsular extension (ECE), seminal vesicle invasion (SVI), and lymphovascular invasion (LVI) [17][18][19].…”

Section: Study Design and Patientsmentioning

confidence: 99%

Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI

Chung¹,

Han²,

Cho³

et al. 2019

European Urology Supplements

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Background: The objective of our study was to evaluate the clinical significance of invisible prostate cancer (iPCa) on multiparametric magnetic resonance imaging (mpMRI) by analyzing clinical parameters and oncologic outcomes. Methods: We retrospectively reviewed the records of patients treated with radical prostatectomy (RP) from 2010 to 2015 at our institution. Before RP, all patients were confirmed to have prostate cancer based on prostate biopsy. We excluded patients who underwent neoadjuvant therapy. Additionally, we excluded patients who had incomplete mpMRI based on PI-RADS (Prostate Imaging Reporting and Data System). iPCa was defined as having no grade 3 or higher region of interests using a scoring system established by PI-RADS without limitations on interpretation from mpMRI by radiologists. We selected patients with iPCa using this protocol. We analyzed data using univariate and multivariate cox regression analysis, logistic analysis, Kaplan-Meier curves, and receiver operator characteristic curves to predict biochemical recurrence (BCR). Results: A total of 213 patients with iPCa were selected according to the patient selection protocol. Among them, pathological findings showed that Gleason score (GS) G6, G7 and ≥ G8 were present in 115 cases (54.0%), 78 cases (36.6%), and 20 cases (9.4%), respectively. Further, extracapsular extension (ECE), positive surgical margins (PSM), and lymphovascular invasion (LVI) were present in 28 (13.1%), 18 (8.5%), and 3 cases (1.4%), respectively. Seminal vesicle invasion (SVI) was observed in one case (0.5%). During a median follow-up time of 51 months, BCR was observed 29 cases. Adverse pathology (AP) was defined as GS ≥8, ECE, SVI and LVI. AP and prostate specific antigen (PSA) were significantly associated with BCR. Moreover, PSA > 6.2 ng/ml was suggested as a cutoff value for predicting BCR. Conclusions: In our results, cases of iPCa had clinically significant PCa, and AP and poor prognosis were also observed in some. Additionally, we found that PSA is the most clinically reliable predictor of oncologic outcome. We suggest that active treatment and diagnosis should be considered for patients with iPCa with PSA > 6.2 ng/ml.

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Clinical Usefulness of Total Length of Gleason Pattern 4 on Biopsy in Men with Grade Group 2 Prostate Cancer

Abstract: Our findings support inclusion of Gleason pattern 4 quantification in pathology reports and risk prediction models for patients with GrdGrp 2/GS 3+4=7 prostate cancer. Total length of GP4 across all cores provides the strongest benefit for prediction of adverse pathology.

Cited by 37 publications

References 19 publications

Predicting Prostate Cancer Death with Different Pretreatment Risk Stratification Tools: A Head-to-head Comparison in a Nationwide Cohort Study

Predicting Prostate Cancer Death with Different Pretreatment Risk Stratification Tools: A Head-to-head Comparison in a Nationwide Cohort Study

The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma

Clinical significance and predictors of oncologic outcome after radical prostatectomy for invisible prostate cancer on multiparametric MRI

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