Optimization of the 2014 Gleason grade grouping in a Canadian cohort of patients with localized prostate cancer

Wissing, Michel D.; Brimo, Fadi; Chevalier, Simone; Scarlata, Eleonora; O'Flaherty, Ana; Aprikian, Saro; Thibodeau, Valérie; Saad, Fred; Carmel, Michel; Lacombe, Louis; Têtu, Bernard; Ekindi-Ndongo, Nadia; Latour, Mathieu; Trudel, Dominique; Aprikian, Armen

doi:10.1111/bju.14512

Cited by 17 publications

(31 citation statements)

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“…Unsurprisingly, comparison with a four‐tier Gleason score grouping (i.e. Gleason scores 6, 7, 8, 9–10) demonstrated the superior prognostic impact of the five‐tiered ISUP grading for both clinical and pathological outcome parameters after prostatectomy . Commonly used clinical risk stratification systems such as D'Amico consider Gleason score 7 as a major criterion for intermediate‐risk prostate cancer.…”

Section: Isup 2014 Grading Of Prostate Cancermentioning

confidence: 99%

“…Gleason scores 6,7,8,[9][10] demonstrated the superior prognostic impact of the five-tiered ISUP grading for both clinical and pathological outcome parameters after prostatectomy. 45,46 Commonly used clinical risk stratification systems such as D'Amico consider Gleason score 7 as a major criterion for intermediate-risk prostate cancer. They may now need to adapt their risk stratification based on ISUP grades.…”

Section: Isup 2014 Grading Of Prostate Cancermentioning

confidence: 99%

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Grading of prostate cancer: a work in progress

2018

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Grading of prostate cancer has evolved substantially over time, not least because of major changes in diagnostic approach and concomitant shifts from late‐ to early‐stage detection since the adoption of PSA testing from the late 1980s. After the conception of the architecture‐based nine‐tier Gleason grading system more than 50 years ago, several changes were made in order to increase its prognostic impact, to reduce interobserver variation and to improve concordance between prostate needle biopsy and radical prostatectomy grading. This eventually resulted in the current five‐tier grading system, with a much more detailed description of the individual architectural patterns constituting the remaining three Gleason patterns (i.e. grades 3–5). Nevertheless, there is room for improvement. For instance, distinction of common grade 4 subpatterns such as ill‐formed and fused glands from the grade 3 pattern is challenging, blurring the division between low‐risk patients who could be eligible for deferred therapy and those who need curative therapy. The last few years have witnessed the publication of several studies on the prognostic impact of individual architectural subpatterns showing that, in particular, the cribriform pattern exceeded the prognostic impact of other grade 4 subpatterns. This review provides an overview of the changes in prostate cancer grading over time and provides a thorough description of the various Gleason subpatterns, the current evidence of their prognostic impact and areas of contention. Potential practical ways for improvements of the current grading system are also put forward.

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Section: Isup 2014 Grading Of Prostate Cancermentioning

confidence: 99%

Section: Isup 2014 Grading Of Prostate Cancermentioning

confidence: 99%

Grading of prostate cancer: a work in progress

2018

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“…Data were collected from the PROCURE cohort and biobank, which has been described previously . Four hospitals in Quebec province, affiliated with McGill University, Université de Montréal, Université de Sherbrooke, and Université Laval, participated in PROCURE.…”

Section: Methodsmentioning

confidence: 99%

Psychosocial adjustment to a prostate cancer diagnosis in a cohort of radical prostatectomy patients in Quebec, Canada

et al. 2019

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Objective The psychosocial impact of a prostate cancer diagnosis significantly affects a patient's quality of life. We studied patient communication at the time of diagnosis and its impact on psychosocial adjustment of patients. Methods This is a cross‐sectional data analysis from self‐administered questionnaires in the PROCURE biobank study, consisting of a cohort of patients with localized prostate cancer undergoing radical prostatectomy in Québec (Canada), 2006 to 2013. Odds ratios (OR) and their respective 95% confidence intervals (95% CI) were calculated using binary or ordered logistic regression models. Results Data from 1841 patients were analyzed. The median age of patients was 62 years (range 41‐80 years), the majority was French‐Canadian (68.3%) and married (79.6%). Most patients (90.1%) considered conversations with their treating physician a useful information source. Patients were dissatisfied on the communication when receiving their diagnosis by telephone (OR = 0.19, 95% CI, 0.11‐0.33). Younger patients were also more dissatisfied. Most patients preferred to receive information on prostate cancer (89.5%) and radical prostatectomy (88.0%) at the time of diagnosis, while only 58.8% and 52.4% of patients received this information at this stage. Patients who were dissatisfied with the communication of the diagnosis had more negative responses, such as increased worries and fear (P < 0.05). The five most useful coping mechanisms were physical activity (62.3%), breathing exercises (44.5%), music (32.8%), faith (30.3%), and muscle relaxation (30.1%), but varied by demographics. Conclusions This study highlights the importance of physicians communicating a prostate cancer diagnosis well to their patients. Patients may benefit from individually tailored interventions to facilitate their overall coping.

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“…Dementsprechend sprechen sich die meisten Studien auch für die Verwendung des neuen Gradings aus. Erwähnenswert bei der Interpretation der Daten ist jedoch, dass in nur 3 Studien eindeutig die Durchführung eines "Re-Gradings" der archivierten Gewebeproben anhand der neuen histomorphologischen Kriterien beschrieben wurde und somit nicht nur ein "Re-Grouping" in die neuen Grade Groups erfolgte [18,19,22].…”

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Das neue ISUP 2014/WHO 2016 Prostatakarzinom-Grading – Status quo 5 Jahre nach seiner Einführung

et al. 2019

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Zusammenfassung Hintergrund Im Jahr 2014 wurde durch die ISUP (International Society of Urological Pathology) eine Modifikation des Gradings für das Prostatakarzinom (PCa) eingeführt, welches 2016 von der Weltgesundheitsorganisation (WHO) anerkannt und übernommen wurde. Neben der Definition von 5 „Grade Groups“ wurden auch einige histomorphologische Kriterien angepasst. Unsere Übersichtsarbeit stellt die Ergebnisse aller aktuellen Studien und deren Bewertungen des neuen Gradings zusammen. Material und Methoden Es erfolgte eine Literaturrecherche in der PubMed-Datenbank. Insgesamt sind aus dem Zeitraum 2016 – 2018 15 Studien identifiziert und in die Übersicht eingeschlossen worden. Ergebnisse Die Hauptziele des neuen ISUP 2014/WHO 2016 PCa-Gradings sind ein (I) präziseres und vereinfachtes Grading, (II) eine verringerte Übertherapie indolenter PCa und (III) eine verbesserte Kommunikation mit den Patienten. Die Mehrzahl der Studien wählte das biochemische Rezidiv als Endpunkt und bescheinigte dem neuen Grading eine höhere prognostische Wertigkeit im Vergleich zum früheren Gleason Grading. Interessanterweise war es jedoch nur in wenigen Studien klar ersichtlich, dass die archivierten Proben tatsächlich auch nach den modifizierten histomorphologischen Kriterien reevaluiert („Re-Grading“) und nicht nur in die neuen „Grade Groups“ übersetzt wurden („Re-Grouping“). Schlussfolgerung Die Mehrheit der analysierten Studien bestätigt die prognostische Wertigkeit des neuen ISUP 2014/WHO 2016 Gradings und empfiehlt dessen weltweite Anwendung. Jedoch muss bei der Interpretation bisheriger Studien berücksichtigt werden, dass das notwendige „Re-Grading“ als korrekte Anwendung des neuen Gradings nicht immer klar ersichtlich war.

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Optimization of the 2014 Gleason grade grouping in a Canadian cohort of patients with localized prostate cancer

Abstract: The five-tier GG system increased accuracy for predicting treatment failure compared with the previous grading systems, but can be further improved.

Cited by 17 publications

References 29 publications

Grading of prostate cancer: a work in progress

Grading of prostate cancer: a work in progress

Psychosocial adjustment to a prostate cancer diagnosis in a cohort of radical prostatectomy patients in Quebec, Canada

Das neue ISUP 2014/WHO 2016 Prostatakarzinom-Grading – Status quo 5 Jahre nach seiner Einführung

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