Validation of the 2015 prostate cancer grade groups for predicting long‐term oncologic outcomes in a shared equal‐access health system

Schulman, Ariel; Howard, Lauren E.; Tay, Kae Jack; Tsivian, Efrat; Sze, Christina; Amling, Christopher L.; Aronson, William J.; Cooperberg, Matthew R.; Kane, Christopher J.; Terris, Martha K.; Freedland, Stephen J.; Polascik, Thomas J.

doi:10.1002/cncr.30844

Cited by 18 publications

(19 citation statements)

References 23 publications

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“…15 The results of the current study demonstrated that this GrGp system also was associated with a postprostatectomy PSA nadir <0.1 ng/mL and histopathology findings. 15 The results of the current study demonstrated that this GrGp system also was associated with a postprostatectomy PSA nadir <0.1 ng/mL and histopathology findings.…”

Section: Discussionsupporting

confidence: 55%

“…15 On a population level, He et al used the Surveillance, Epidemiology, and End Results database to validate the predictive value of the GrGp system for prostate cancer-specific mortality. Recently, using the SEARCH database, our group demonstrated that a higher biopsy GrGp was associated with an increased risk of BCR (hazard ratio [HR], 1.92-5.42), metastasis (HR, 9.79-72.2), and all-cause mortality (HR, 1.38-2.20).…”

Section: Discussionmentioning

confidence: 99%

“…10 Having been incorporated into the 2016 World Health Organization classification of urinary tract tumors, 11 several studies demonstrated the prognostic value of the GrGp system when predicting long-term oncological outcomes with regard to biochemical disease progression, metastasis, and cancer-specific survival rates. [12][13][14][15] Furthermore, several studies have indicated that adverse pathologic features on prostatectomy specimens can predict oncological outcome. For example, Imnadze et al demonstrated that for patients with GrGp ≥3 or with extraprostatic extension on the prostatectomy specimen, the risk of 5-year biochemical disease recurrence (BCR) is significantly higher (>40% when compared with patients with a lower GrGp).…”

Section: Another Evaluation By Billis Et Almentioning

confidence: 99%

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Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy

Aminsharifi

Schulman

Howard

et al. 2019

Cancer

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BACKGROUND:The current study was performed to evaluate the influence of race on the association between biopsy grade group (GrGp) and the risk of detectable prostate-specific antigen (PSA) and adverse histopathological outcomes after radical prostatectomy (RP). METHODS: Data regarding 4073 men (1344 African American men; 33%) who were treated with RP were categorized based on the 5-tiered GrGp system. Logistic regression was used to test the association between biopsy GrGp and PSA nadir (<0.1 ng/mL) after RP as well as adverse pathological features among all patients and stratified by race. RESULTS: Those patients with a higher biopsy GrGp were found to have lower odds of achieving a PSA nadir <0.1 ng/mL after RP on unadjusted and multivariable analysis (both P < .001). On unadjusted and multivariable analysis, higher GrGp was associated with increased odds of each of the adverse pathological features, namely, GrGp ≥3, extraprostatic extension, seminal vesicle invasion, positive surgical resection margin, and positive lymph nodes (all P < .001). Race had no significant interaction with biopsy GrGp in the prediction of PSA nadir after RP (P = .91) or any adverse pathological features (all P > .06) except positive lymph nodes. When the models were stratified by race, the associations between preoperative biopsy GrGp and having a PSA nadir <0.1 ng/mL, high-grade final pathology, or other adverse histopathologic features were similar in both races except as noted for positive lymph nodes. CONCLUSIONS: Higher preoperative biopsy GrGp is associated with increased odds of adverse histopathological findings as well as lower odds of a PSA nadir <0.1 ng/mL after RP. These associations are largely independent of race, suggesting that GrGp is an accurate tool for risk stratification in both black and white men. Cancer 2019;125:3025-3032.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Another Evaluation By Billis Et Almentioning

confidence: 99%

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Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy

Aminsharifi

Schulman

Howard

et al. 2019

Cancer

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“…Schulman et al. examined an equal‐access health system with >2500 men diagnosed with prostate cancer, of whom 41% were AA and found race to not be predictive of prostate cancer outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, Leapman et al [4] examined 895 men with LR-prostate cancer and equal access to medical care, of whom 40% were AA, and found no significantly higher risks of pathological or stage upgrading, positive surgical margins, or BCR. Schulman et al [26] examined an equal-access health system with >2500 men diagnosed with prostate cancer, of whom 41% were AA and found race to not be predictive of prostate cancer outcomes.…”

Section: Discussionmentioning

confidence: 99%

Use of multiparametric magnetic resonance imaging and fusion‐guided biopsies to properly select and follow African‐American men on active surveillance

et al. 2019

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Objectives To determine the rate of Gleason Grade Group (GGG) upgrading in African‐American (AA) men with a prior diagnosis of low‐grade prostate cancer (GGG 1 or GGG 2) on 12‐core systematic biopsy (SB) after multiparametric magnetic resonance imaging (mpMRI) and fusion biopsy (FB); and whether AA men who continued active surveillance (AS) after mpMRI and FB fared differently than a predominantly Caucasian (non‐AA) population. Patients and methods A database of men who had undergone mpMRI and FB was queried to determine rates of upgrading by FB amongst men deemed to be AS candidates based on SB prior to referral. After FB, Kaplan–Meier curves were generated for AA men and non‐AA men who then elected AS. The time to GGG upgrading and time continuing AS were compared using the log‐rank test. Results AA men referred with GGG 1 disease on previous SB were upgraded to GGG ≥3 by FB more often than non‐AA men, 22.2% vs 12.7% (P = 0.01). A total of 32 AA men and 258 non‐AA men then continued AS, with a median (interquartile range) follow‐up of 39.19 (24.24–56.41) months. The median time to progression was 59.7 and 60.5 months, respectively (P = 0.26). The median time continuing AS was 61.9 months and not reached, respectively (P = 0.80). Conclusions AA men were more likely to be upgraded from GGG 1 on SB to GGG ≥3 on initial FB; however, AA and non‐AA men on AS subsequently progressed at similar rates following mpMRI and FB. A greater tendency for SB to underestimate tumour grade in AA men may explain prior studies that have shown AA men to be at higher risk of progression during AS.

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Validation of the 2015 prostate cancer grade groups for predicting long‐term oncologic outcomes in a shared equal‐access health system

Abstract: The 5-tier GG system predicted multiple long-term endpoints after radical prostatectomy in an equal-access health system. The predictive value was consistent across races. Cancer 2017;123:4122-4129. © 2017 American Cancer Society.

Cited by 18 publications

References 23 publications

Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy

Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy

Use of multiparametric magnetic resonance imaging and fusion‐guided biopsies to properly select and follow African‐American men on active surveillance

Der aktuelle Stand beim Gleason-Score

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