Michael S Leapman1, Janet E Cowan2, Jeffry Simko3, Gray Roberge2, Bradley A Stohr4, Peter R Carroll2, Matthew R Cooperberg5. 1. Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; Department of Urology, Yale University School of Medicine, New Haven, CT, USA. Electronic address: michael.leapman@yale.edu. 2. Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA. 3. Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; Department of Pathology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA. 4. Department of Pathology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA. 5. Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
Abstract
BACKGROUND: There is growing enthusiasm for the adoption of a novel grade grouping system to better represent Gleason scores. OBJECTIVE: To evaluate the ability of prognostic Gleason grade groups to predict prostate cancer (PCa)-specific mortality (PCSM) and bone metastatic progression. DESIGN, SETTING, AND PARTICIPANTS: We identified patients with PCa enrolled in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry across treatment strategies, including conservative and nondefinitive therapy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We examined the prognostic ability of Gleason grade groups to predict risk of PCSM and bone metastasis using the Kaplan-Meier method and unadjusted and adjusted Cox proportional hazards models. RESULTS AND LIMITATIONS: We identified 10529 men with PCa followed for a median of 81 mo (interquartile range 40-127), including 64% in group I (< 3 + 4); 17% in group II (3+4); 9% in group III (4+3); 6% in group IV (4+4); and 4% in group V (≥ 4 + 5). Relative to grade group I, the unadjusted risks of PCSM and bone metastasis were significantly associated with prognostic grade groupings for both biopsy and prostatectomy samples (all p<0.01). Pairwise comparisons within Gleason sums collapsed within grade group V were not significant; however, this analysis was limited by a small representation of men with Gleason pattern ≥ 4 + 5. CONCLUSIONS: The prognostic grade grouping system is associated with risk of PCSM and metastasis across management strategies, including definitive therapy, conservative management, and primary androgen deprivation. PATIENT SUMMARY: A five-level reporting system for prostate cancer pathology is associated with the risk of late prostate cancer endpoints.
BACKGROUND: There is growing enthusiasm for the adoption of a novel grade grouping system to better represent Gleason scores. OBJECTIVE: To evaluate the ability of prognostic Gleason grade groups to predict prostate cancer (PCa)-specific mortality (PCSM) and bone metastatic progression. DESIGN, SETTING, AND PARTICIPANTS: We identified patients with PCa enrolled in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry across treatment strategies, including conservative and nondefinitive therapy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We examined the prognostic ability of Gleason grade groups to predict risk of PCSM and bone metastasis using the Kaplan-Meier method and unadjusted and adjusted Cox proportional hazards models. RESULTS AND LIMITATIONS: We identified 10529 men with PCa followed for a median of 81 mo (interquartile range 40-127), including 64% in group I (< 3 + 4); 17% in group II (3+4); 9% in group III (4+3); 6% in group IV (4+4); and 4% in group V (≥ 4 + 5). Relative to grade group I, the unadjusted risks of PCSM and bone metastasis were significantly associated with prognostic grade groupings for both biopsy and prostatectomy samples (all p<0.01). Pairwise comparisons within Gleason sums collapsed within grade group V were not significant; however, this analysis was limited by a small representation of men with Gleason pattern ≥ 4 + 5. CONCLUSIONS: The prognostic grade grouping system is associated with risk of PCSM and metastasis across management strategies, including definitive therapy, conservative management, and primary androgen deprivation. PATIENT SUMMARY: A five-level reporting system for prostate cancer pathology is associated with the risk of late prostate cancer endpoints.
Authors: Ariel A Schulman; Lauren E Howard; Kae Jack Tay; Efrat Tsivian; Christina Sze; Christopher L Amling; William J Aronson; Matthew R Cooperberg; Christopher J Kane; Martha K Terris; Stephen J Freedland; Thomas J Polascik Journal: Cancer Date: 2017-06-29 Impact factor: 6.860
Authors: Tamara L Lotan; Harsimar B Kaur; Abdullah M Alharbi; Colin C Pritchard; Jonathan I Epstein Journal: Histopathology Date: 2019-04-01 Impact factor: 5.087
Authors: François Audenet; Emily A Vertosick; Samson W Fine; Daniel D Sjoberg; Andrew J Vickers; Victor E Reuter; James A Eastham; Peter T Scardino; Karim A Touijer Journal: J Urol Date: 2017-10-10 Impact factor: 7.450
Authors: Janggun Jo; Javed Siddiqui; Yunhao Zhu; Linyu Ni; Sri-Rajasekhar Kothapalli; Scott A Tomlins; John T Wei; Evan T Keller; Aaron M Udager; Xueding Wang; Guan Xu Journal: Opt Lett Date: 2020-11-01 Impact factor: 3.776
Authors: Sarah R Amend; Gonzalo Torga; Ke-Chih Lin; Laurie G Kostecka; Angelo de Marzo; Robert H Austin; Kenneth J Pienta Journal: Prostate Date: 2019-08-02 Impact factor: 4.104
Authors: Marvin C J Lim; Anne-Marie Baird; John Aird; John Greene; Dhruv Kapoor; Steven G Gray; Ray McDermott; Stephen P Finn Journal: Diagnostics (Basel) Date: 2018-08-30