Primary Gleason grade and Gleason grade group at positive surgical margins: a systematic review and meta‐analysis

John, Athul; John, Hritik; Catterwell, R.; Selth, Luke A.; Callaghan, Michael O

doi:10.1111/bju.15316

Cited by 15 publications

(14 citation statements)

References 41 publications

(101 reference statements)

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“…Gleason grade was another important biomarker in PC ( Sopyllo, Erickson & Mirtti, 2021 ; Moris et al, 2020 ). Recently, a meta-analysis found that Gleason grade was positively associated with recurrence after surgery ( John et al, 2021 ). Gleason scoring system mainly concentrated on the pathological structure of PC, while the transcriptomic and genomic features were missed.…”

Section: Discussionmentioning

confidence: 99%

Prognostic values of the core components of the mammalian circadian clock in prostate cancer

Yue

Wang

et al. 2021

PeerJ

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Background Prostate cancer (PC) is one of the most common malignancies in males. Extensive and complex connections between circadian rhythm and cancer were found. Nonetheless, in PC, the potential role of the core components of the mammalian circadian clock (CCMCCs) in prognosis prediction has not been fully clarified. Methods We firstly collected 605 patients with PC from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) databases. Survival analysis was carried out for each CCMCC. Then, we investigated the prognostic ability of CCMCCs by Cox regression analysis. Independent prognostic signatures were extracted for the establishment of the circadian clock-based risk score model. We explored the predictive performance of the risk score model in the TCGA training cohort and the independent GEO dataset. Finally, the relationships between risk score and clinicopathological parameters, biological processes, and signaling pathways were evaluated. Results The expression levels of CCMCCs were widely correlated with age, tumor status, lymph node status, disease-free survival (DFS), progression-free survival (PFS), and overall survival (OS). Nine circadian clock genes, including CSNK1D, BTRC, CLOCK, CSNK1E, FBXL3, PRKAA2, DBP, NR1D2, and RORB, were identified as vital prognostic factors in PC and were used to construct the circadian clock-based risk score model. For DFS, the area under the 3-year or 5-year receiver operating characteristic curves ranged from 0.728 to 0.821, suggesting better predictive performance. When compared with T3-4N1 stage, PC patients at T2N0 stage might be benefited more from the circadian clock-based risk score model. Furthermore, a high circadian clock-based risk score indicated shorter DFS (p < 0.0001), early progression (p < 0.0001), and higher 5-year death rate (p = 0.007) in PC. The risk score was related to tumor status (p < 0.001), lymph node status (p < 0.001), and ribosome-related biogenesis and pathways. Conclusions The vital roles of circadian clock genes in clinical outcomes were fully depicted. The circadian clock-based risk score model could reflect and predict the prognosis of patients with PC.

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Section: Discussionmentioning

confidence: 99%

Prognostic values of the core components of the mammalian circadian clock in prostate cancer

Yue

Wang

et al. 2021

PeerJ

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“…Gleason score of the tumor at the positive margin has also been associated with the prognosis [ 58 , 59 , 60 , 61 ], albeit in some studies it has been found that it is not an independent factor [ 47 ]. A recent meta-analysis of 10 retrospective cohort studies, found that primary Gleason grade 4 or 5 at the margin was predictive of biochemical-free recurrence [ 62 ]. Prognostic grade group (PGG) 1 at the margin has been shown to have biochemical recurrence rates [ 60 ] and cancer-specific survival [ 61 ] equivalent to those of negative margins.…”

Section: Pathologic Features Of Positive Margins With Clinical Significancementioning

confidence: 99%

Radical or Not-So-Radical Prostatectomy: Do Surgical Margins Matter?

Grypari

Zolota

Tzelepi

2021

Cancers

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Prostate cancer is the second most common malignancy in men, and prostatectomy is the treatment of choice for most patients with at least low risk of progression. The presence of positive margins in the radical prostatectomy specimen is considered an adverse pathologic feature, and may prompt additional therapeutic intervention in the patients. The absence of a distinct capsule around the prostate and intraoperative manipulations that aim to minimize postoperative adverse effects, complicate its wide removal. Proper handling of the specimen during the gross processing is essential for accurate determination of the status of margins or resection. Positive margins, defined as the presence of neoplastic glands in the highlighted-with-ink margin of resection, range from 6–38%. The surgical technique, surgeon’s expertise and tumor (i.e., grade and stage) and patients’ (i.e., BMI) characteristics affect the rate of margin positivity. Extensive or multifocal and nonanterior/nonapical positive margins are linked with higher recurrence rates, especially in organ-confined disease, underscoring the need for treating these patients more aggressively. In summary, detailed description of the status of the margins should be performed in every pathology report to determine patients’ prognosis and the most appropriate therapeutic plan.

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“…However, the clinical significance of PSM after RP is controversial, with 27-44% of patients developing BCR, 6.8-24.3% with systemic progression, and prostate cancerrelated mortality ranging from 0.8% to 3.7% within 7-13 years of follow-up. 3 So far, several parameters associated with PSM, including Gleason grade and margin length at PSM as well as the location of PSM, were reported to be associated with BCR after RP. 3,5 Among these PSM-associated parameters, in a study by Matsuda et al, the impact of nerve sparing in RP on the location of PSM and its effect on BCR was investigated, and two important findings are reported.…”

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confidence: 99%

“…3 So far, several parameters associated with PSM, including Gleason grade and margin length at PSM as well as the location of PSM, were reported to be associated with BCR after RP. 3,5 Among these PSM-associated parameters, in a study by Matsuda et al, the impact of nerve sparing in RP on the location of PSM and its effect on BCR was investigated, and two important findings are reported. 6 One finding is that PSM in the anterior apex was not associated with the risk of BCR after RP.…”

mentioning

confidence: 99%

“…2 PSM has been reported in 11-40% of men who underwent RP and is associated with a worse prognosis and a higher risk of receiving a secondary treatment compared with negative surgical margin. 3 It is necessary to resect tumor tissue widely with enough surrounding tissues of the prostate to avoid PSM for better cancer control. Meanwhile, preserving tissues such as nerve is important for recovery of potency and continence.…”

mentioning

confidence: 99%

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