One is the new six: The International Society of Urological Pathology (ISUP) patient-focused approach to Gleason grading

Srigley, John R.; Delahunt, Brett; Egevad, Lars; Samaratunga, Hemamali; Yaxley, John; Evans, Andrew

doi:10.5489/cuaj.4146

Cited by 20 publications

(14 citation statements)

References 34 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although this scoring system has been used for a long time by the uropathologists, some publications were the subject of criticism due to the discrepancy rates between biopsy and RP pathologies. [10][11][12] Therefore, a five-step grading system was defined by the International Society of UroPathologists (ISUP) in 2014 to clarify the clinically insignificant cancer group. With this definition, the rate of metastases, and upgrading were suggested to be lower in Grade Group 1 (namely, Gleason score 6) tumors.…”

Section: Discussionmentioning

confidence: 99%

“…Donald Gleason developed a grading system for PCa approximately 50 years ago. Although this scoring system has been used for a long time by the uropathologists, some publications were the subject of criticism due to the discrepancy rates between biopsy and RP pathologies . Therefore, a five‐step grading system was defined by the International Society of UroPathologists (ISUP) in 2014 to clarify the clinically insignificant cancer group.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The pathological upgrading after radical prostatectomy in low‐risk prostate cancer patients who are eligible for active surveillance: How safe is it to depend on bioptic pathology?

et al. 2019

View full text Add to dashboard Cite

Background Active surveillance (AS) is one of the treatment alternatives in low‐risk prostate cancer (PCa). The pathological upgrading after radical prostatectomy (RP) were investigated in patients who were eligible for AS in the present study. Methods Between August 2006 and July 2017, 627 patients underwent RP in our institution. One hundred and thirty‐six patients who were eligible for AS at the time of RP were included in this study. The previously defined AS criteria Gleason 3 + 3=6 adenocarcinoma at maximum two biopsy cores, prostate‐specific antigen (PSA) < 10 ng/mL and clinical T stage ≤ 2a were used in the study. The demographics, clinical, and histopathological outcomes were retrospectively compared between two groups, which were divided in accordance with the upgrading status at final pathology as Group 1 (n = 67, upgrading) and Group 2 (n = 69, nonupgrading). Results Gleason upgrading (GU) was found in 67 (49.3%) patients, and 17 patients (12.5%) were upstaged to pT3a. The upgrading to Gleason 3 + 4 was reported in 38.7% of patients, however, 7.4%, and 3.7% of the patients were upgraded to Gleason 4 + 3, and Gleason 4 + 4, respectively. The 10.3% of the patients had extraprostatic involvement, and the rate (19.4% vs 1.4%, P = .002) was significantly higher in Group 1. PSA density (P = .001), tumor size (P < .001), tumor percentage (P < .001), apical involvement (P = .013), and perineural invasion (P < .001) in RP specimen were higher in Group 1. Multivariate analysis showed that perineural invasion (OR = 4.26; 95%CI: 1.76‐10.33; P = .001) and pathologic T stage (OR = 5.45; 95%CI: 1.08‐27.4; P = .04) were independently associated with GU. Conclusions Since 12.5% of the patients upstaged to pT3a disease, and there is a possible risk of Gleason 4 pattern, upgrading of the tumor should carefully be kept in mind before offering AS to low‐risk patients with PCa.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The pathological upgrading after radical prostatectomy in low‐risk prostate cancer patients who are eligible for active surveillance: How safe is it to depend on bioptic pathology?

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Immediate treatment is recommended for patients whose tumor biopsies are assigned a high Gleason score. In contrast, patients with tumor biopsies with a low Gleason score are considered indolent and monitored without therapeutic intervention to minimize overtreatment (3). The concern is, however, that active surveillance may miss the opportunity for early intervention of tumors that are seemingly low risk but actually are aggressive (4).…”

mentioning

confidence: 99%

TIP5 primes prostate luminal cells for the oncogenic transformation mediated by PTEN -loss

Pietrzak

Kuzyakiv

Simon

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Prostate cancer (PCa) is the second leading cause of cancer death in men. Its clinical and molecular heterogeneities and the lack of in vitro models outline the complexity of PCa in the clinical and research settings. We established an in vitro mouse PCa model based on organoid technology that takes into account the cell of origin and the order of events. Primary PCa with deletion of the tumor suppressor gene PTEN (PTEN-del) can be modeled through Pten-down-regulation in mouse organoids. We used this system to elucidate the contribution of TIP5 in PCa initiation, a chromatin regulator that is implicated in aggressive PCa. High TIP5 expression correlates with primary PTEN-del PCa and this combination strongly associates with reduced prostate-specific antigen (PSA) recurrence-free survival. TIP5 is critical for the initiation of PCa of luminal origin mediated by Pten-loss whereas it is dispensable once Pten-loss mediated transformation is established. Cross-species analyses revealed a PTEN gene signature that identified a group of aggressive primary PCas characterized by PTEN-del, high-TIP5 expression, and a TIP5-regulated gene expression profile. The results highlight the modeling of PCa with organoids as a powerful tool to elucidate the role of genetic alterations found in recent studies in their time orders and cells of origin, thereby providing further optimization for tumor stratification to improve the clinical management of PCa.

show abstract

“…The lack of distinct difference may be due to the very mixed nature of the cohort being managed conservatively. An examination of the differences in outcomes between patterns (3 + 5 vs 4 + 4 vs 5 + 3) within grade group IV, which remains controversial [ 28 , 29 ], was beyond the scope of this paper.…”

Section: Discussionmentioning

confidence: 99%

Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings

et al. 2017

View full text Add to dashboard Cite

BackgroundA new 5-tiered grading grouping system has recently been endorsed for reporting of prostate cancer (PCa) grade to better reflect escalating risk of progression and cancer death. While several validations of the new grade groupings have been undertaken, most have involved centralised pathological review by specialist urological pathologists.MethodsParticipants included 4268 men with non-metastatic PCa diagnosed between 2006 and 2013 from the multi-institutional South Australia Prostate Cancer Clinical Outcomes Collaborative registry. PCa-specific survival and biochemical recurrence-free survival were compared across the five grade groups using multivariable competing risk regression.ResultsFor the entire cohort, risk of PCa death increased with increasing grade groups (at biopsy) Adjusted subdistribution-hazard ratios [sHR] and 95% confidence intervals [95%CI] were: 2.2 (1.5–3.6); 2.5 (1.6–4.2); 4.1 (2.6–6.7) and 8.7 (4.5–14.0) for grade groups II (pattern 3 + 4), III (pattern 4 + 3), IV (total score 8) and V (total score 9–10) respectively, relative to grade group I (total score < =6). Clear gradients in risk of PCa death were observed for radical prostatectomy (RP), but were less clear for those who had radiotherapy (RT) with curative intent and those who were managed conservatively. Likewise, risk of biochemical recurrence increased across grade groups, with a strong and clear gradient for men undergoing RP [sHR (95%CI): 2.0 (1.4–2.8); 3.8 (2.9–5.9); 5.3 (3.5–8.0); 11.2 (6.5–19.2) for grade groups II, III, IV and V respectively, relative to grade group I], and a less clear gradient for men undergoing RT.ConclusionIn general, the new five-tiered grade groupings distinguished PCa survival and recurrence outcomes for men with PCa. The absence of a clear gradient for RT may be due to heterogeneity in this patient group.

show abstract

One is the new six: The International Society of Urological Pathology (ISUP) patient-focused approach to Gleason grading

Abstract: N/A

Cited by 20 publications

References 34 publications

The pathological upgrading after radical prostatectomy in low‐risk prostate cancer patients who are eligible for active surveillance: How safe is it to depend on bioptic pathology?

The pathological upgrading after radical prostatectomy in low‐risk prostate cancer patients who are eligible for active surveillance: How safe is it to depend on bioptic pathology?

TIP5 primes prostate luminal cells for the oncogenic transformation mediated by PTEN -loss

Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings

Contact Info

Product

Resources

About