The new ISUP 2014/WHO 2016 prostate cancer grade group system: first résumé 5 years after introduction and systemic review of the literature

Offermann, Anne; Hupe, Marie C.; Sailer, Verena; Merseburger, Axel S.; Perner, S.

doi:10.1007/s00345-019-02744-4

Cited by 14 publications

(13 citation statements)

References 24 publications

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“…The Gleason grading system revisions aimed at improving inter-pathologist agreement and, ultimately, prostate cancer prognostication (91,92,95). To evaluate improvements in prognostication, a direct comparison of the Gleason scores assigned according to the different Gleason grading systems is necessary (98). However, only a few studies have compared the ISUP 2005 Gleason score to the pre-2005 Gleason score in predicting BCR and found either a small (99,100) or no improvement (101).…”

Section: Impact Of the Gleason Grading System Revisions On Prostate Cmentioning

confidence: 99%

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: Impact Of the Gleason Grading System Revisions On Prostate Cmentioning

confidence: 99%

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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“…However, in the vast majority of studies, GG was created in the same manner, and the present results are comparable with other available reports in this field. 6 A relatively low number of final events (CP and CRD) could reduce the statistical power of our findings. Furthermore, CP was assessed using conventional methods.…”

Section: Discussionmentioning

confidence: 88%

“…Finally, just a few studies, as was shown in a recent literature review, re-evaluated samples according to the 2014 ISUP recommendations. 6 Indeed, the majority of them were retrospective cohort studies in which the historical GS was simply transformed into the corresponding GG. This methodology has the risk of introducing the false perception of an improved prognostic accuracy when using the GG system, while in fact such studies are a confirmation of the usefulness of the long-used GS.…”

Section: Discussionmentioning

confidence: 99%

“…5 A recent literature review concluded that the majority of studies support an improved prognostic accuracy of GG compared with the former Gleason grading, and has recommended to endorse its worldwide application. 6 However, the main end-point in the majority of these studies was BCR, which is the same end-point as in the first GG validation study by Epstein et al 7 Currently, the impact of GG on other clinical end-points, such as CPFS and CSS, is unclear; the existing data are controversial and require more evidence. [8][9][10][11][12][13] Furthermore, very few studies paid attention to patient stratification using a GG model.…”

Section: Introductionmentioning

confidence: 99%

“…The new GG was accepted by the World Health Organization in 2016, 4 and recommended by the EAU 5 . A recent literature review concluded that the majority of studies support an improved prognostic accuracy of GG compared with the former Gleason grading, and has recommended to endorse its worldwide application 6 . However, the main end‐point in the majority of these studies was BCR, which is the same end‐point as in the first GG validation study by Epstein et al 7 .…”

Section: Introductionmentioning

confidence: 99%

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Benefits and harms of the new prostate cancer grade grouping on the prediction of long‐term oncological outcomes in patients after radical prostatectomy

et al. 2021

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To investigate whether the new prostate cancer grade groups model provides significant predictive value and better patient stratification on tumor progression after radical prostatectomy compared with the former Gleason grading models. Methods: Men treated at a tertiary center by radical prostatectomy between 2005 and 2017 were analyzed. The outcomes of interest were clinical progression-free and cancerspecific survival. Multivariate Cox regression analysis, C-index and decision curve analysis were carried out using three-tier (Gleason score 6, 7 and 8-10), four-tier (Gleason score 6, 7, 8 and 9-10) and new grade groups model. Results: In total, 1759 men were included in the analysis. At a median of 87 months (interquartile range 51-134 months) of follow up, clinical progression was detected in 78 (4.4%) and cancer-related death in 42 (2.4%) patients. The hazard ratio of clinical progression-free was 2.3, 5.7, 5.2 and 29.5; the hazard ratio of cancer-specific survival was 1.7, 3.2, 4.8 and 11.8 in the grade groups 2-5, relative to grade group 1, respectively. The grade groups model had higher C-index in comparison with four-and three-tier grading models for clinical progression-free survival 0.88 versus 0.85 versus 0.83 and for cancer-specific survival 0.82 versus 0.80 versus 0.80, respectively. In the decision curve analysis, the grade groups model shows marginally better net benefit on clinical progression-free and cancer-specific survival.Conclusions: The new model shows better performance in comparison with former Gleason grading models on the prediction of long-term oncological outcomes.

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Prevalence of adverse pathology features in grade group 2 prostatectomy specimens with syn‐ or metachronous metastatic disease

Downes

Jain

et al. 2021

The Prostate

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Background: To validate the importance of recently established adverse histopathology features (cribriform pattern and intraductal carcinoma) as contraindication for deferred treatment of Gleason score 7 (3 + 4) (grade group [GG] 2) prostate cancer, we investigated their frequency in GG2 radical prostatectomies with syn-or metachronous metastatic disease.Methods: GG2 prostatectomy specimens of patients with concomitant lymph node metastasis or distant metastasis at follow-up were identified in a clinical database of a tertiary care center and their pathology was reviewed for pathological stage, lymphovascular invasion, Gleason grade 4 subpatterns, presence of tertiary grade 5, and ductal adenocarcinoma histology. A control group of 99 GG2 prostatectomy specimens who had no metastatic disease (controls) was reviewed for the same adverse pathological features.Results: Of 1860 GG2 prostatectomy specimens (operated between 2002 and 2020), 45 (2.4%) had concurrent regional lymph node metastases or distant metastases at follow-up. Pathological stage distribution of cases and controls was 24% and 79% pT2, 42% and 15% pT3a, 33% and 6.1% pT3b -T4, respectively (p < 0.001).Eleven of 45 cases (24%) had ≤10% Gleason grade 4 component. Cribriform pattern or intraductal carcinoma was present in 84% of cases versus 34% of controls (p < 0.001), tertiary grade 5 in 16% of cases versus 5% controls (p = 0.05) and ductal adenocarcinoma in 16% of cases versus 2% of controls (p = 0.004). Among the seven cases without cribriform or intraductal carcinoma, two displayed ductal adenocarcinoma features.Conclusions: Well-established unfavorable histopathologic features (intraductal and cribriform pattern carcinoma, ductal adenocarcinoma) are represented in about 90% of GG2 prostate cancers with local or distant metastatic disease and are much less common (38%) in those without metastatic disease. Strikingly, about 25% of GG2 prostatectomy cases with metastatic disease had an organ-confined disease and/or a small percentage of Gleason grade 4 pattern. This further emphasizes the relative

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The new ISUP 2014/WHO 2016 prostate cancer grade group system: first résumé 5 years after introduction and systemic review of the literature

Cited by 14 publications

References 24 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

Benefits and harms of the new prostate cancer grade grouping on the prediction of long‐term oncological outcomes in patients after radical prostatectomy

Prevalence of adverse pathology features in grade group 2 prostatectomy specimens with syn‐ or metachronous metastatic disease

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