Application of a Prognostic Gleason Grade Grouping System to Assess Distant Prostate Cancer Outcomes

Abstract

A five-level reporting system for prostate cancer pathology is associated with the risk of late prostate cancer endpoints.

Polyploid giant cancer cells: Unrecognized actuators of tumorigenesis, metastasis, and resistance

“…Four of seven (57%) men who had a previous history of PCa were dead at a median of 7 months after diagnosis of recurrent PCa. This is in grim contrast to the reported PCa‐specific mortality of <5% at 2 years and 10% at 4 years for men with similar nonmetastatic PCa diagnoses (Gleason score 9 and 10) . Notably, despite their apparent role in mediating aggressive disease, PGCCs typically make up a small minority of the assessed tumor region (5%‐20%).…”

“…This is in grim contrast to the reported PCa-specific mortality of <5% at 2 years and 10% at 4 years for men with similar nonmetastatic PCa diagnoses (Gleason score 9 and 10). 112 Notably, despite their apparent role in mediating aggressive disease, PGCCs typically make up a small minority of the assessed tumor region (5%-20%). These striking data highlight the likely role for these keystone PGCCs as actuators of rapid lethal disease progression.…”

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

“…The seminal article by Epstein et al in 2016 validated the GG system in 20,845 men after radical prostatectomy (RP) and 5501 men after radiotherapy using post‐treatment prostate‐specific antigen (PSA) recurrence as an endpoint . Recently, validation of the GG system in other cohorts of men has demonstrated encouraging results, and several recent publications have reported the efficacy of prostate GGs for predicting long‐term endpoints, including prostate cancer‐specific mortality (PCSM) …”

“…4 Recently, validation of the GG system in other cohorts of men has demonstrated encouraging results, and several recent publications have reported the efficacy of prostate GGs for predicting long-term endpoints, including prostate cancer-specific mortality (PCSM). [11][12][13][14][15][16] In this study, we tested the validity of the GG system for predicting multiple long-term oncologic endpoints in the Shared Equal Access Research (SEARCH) database, which consists of patients from 6 Veterans Affairs hospitals in the United States. The population is particularly interesting because of the high rate of sustained continuity of care, the presence of fewer socioeconomic confounders than other health care networks, and the large number of African American (AA) men (>32% in each GG group).…”

Improving quality through clinical registries in urology

“…Despite these limitations, CaPSURE investigators have contributed over 200 publications to the urologic literature including recent validation of the new prognostic grade group system[19]; the effect of immediate versus delayed hormone therapy for biochemically recurrent prostate cancer[20]; the impact of age on quality of life outcomes after treatment[21]; and long-term patient reported quality of life outcomes after localized treatment for prostate cancer. [22] Not unlike MUSIC, CaPSURE has mechanisms in place for practice improvement interventions though as of late, most of the CaPSURE studies seem to focus on the estimation of treatment effects or measures of associations rather than provider and practice feedback for quality improvement purposes.…”