Biopsy undergrading in men with Gleason score 6 and fatal prostate cancer in the European Randomized study of Screening for Prostate Cancer Rotterdam

Alberts, Arnout R.; Bokhorst, Leonard P.; Kweldam, Charlotte F.; Schoots, Ivo G.; Kwast, Theodorus H. van der; Leenders, Geert J.L.H. van; Roobol, Monique J.

doi:10.1111/iju.13294

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…Recent reports showed that BCR in patients with latent GP5 was 57% at 5 years, which was almost equal to BCR of the high-risk group and 4+3+tertiary GP5 (5,15). Even if patients were diagnosed as having low-risk for PC, the Rotterdam randomized study of screening for PC showed that 15 patients out of 98 (15%) died of cancer (16). Primary GP4, >50% positive biopsy cores, or having more than one D'Amico intermediate-risk factor (i.e., stage cT2b, PSA levels of 10-20 ng/ml, or GS7) was known to be poor prognostic factors in the intermediate-risk group (17).…”

Section: Discussionmentioning

confidence: 99%

Aggressive Cancer Behavior of Latent Gleason Pattern 5 in Prostatectomy Specimens

et al. 2018

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Background/Aim: The aim of this study was to demonstrate the clinical significance of latent Gleason pattern (GP) 5 occasionally found in prostatectomy specimens. Materials and Methods: Patients (n=605) undergoing radical prostatectomy were classified into three groups according to the presence of GP5 in the biopsy or in the prostatectomy specimens: 'GP5 negative' , absence of GP in both specimens 'latent GP5', absence of GP5 in the biopsy specimen, but presense of GP5 in the prostatectomy specimen, and 'GP5 positive', presense of GP in both specimens. The characteristics of these three groups were analyzed. Results: There were 381 men in the GP5-negative group, 155 in the latent GP5 group, and 69 in the GP5positive group. Low-or intermediate-risk for prostate cancer, latent GP5 and surgical margin positivity were independent predictors of biochemical recurrence (Hazard ratio (HR): 3.1, 5.8, respectively, p=0.001, 0.0002, respectively). Conclusion: Latent GP5 is an important prognostic factor that should be evaluated in patients with low-and intermediate-risk for prostate cancer before the initiation of treatment.

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Section: Discussionmentioning

confidence: 99%

Aggressive Cancer Behavior of Latent Gleason Pattern 5 in Prostatectomy Specimens

et al. 2018

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“…Demographic (age, body mass index, comorbidities), clinical (PSA, PSAD) mpMRI related (prostate weight, LD, lesion location), and pathological (biopsy International Society of Urological Pathology [ISUP] grade) data of all patients were evaluated. The pathological assessment of ≥ ISUP grade 1 was defined as PCa and ≥ ISUP grade 2 as csPCa [6]. PSAD was calculated as total PSA level (ng/mL)/prostate weight (cc).…”

Section: Methodsmentioning

confidence: 99%

The Value of Prostate-Specific Antigen Density in Combination with Lesion Diameter for the Accuracy of Prostate Cancer Prediction in Prostate Imaging-Reporting and Data System 3 Prostate Lesions

Senel,

Koudonas,

Uzun

et al. 2023

Urol Int

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Introduction: The aim of the study was to investigate the value of prostate-specific antigen density (PSAD) and lesion diameter (LD) combination in prostate cancer (PCa) detection. Methods: 181 patients who were detected to have prostate imaging-reporting and data system (PI-RADS) 3 lesions in mpMRI and underwent prostate biopsies were included in the study. Demographic, clinical, and pathological data of all patients were evaluated. The patients were divided into four groups according to PSAD and LD status (PSAD <0.15 ng/mL/cc + LD <1 cm, PSAD <0.15 ng/mL/cc + LD ≥1 cm, PSAD ≥0.15 ng/mL/cc + LD <1 cm, and PSAD ≥0.15 ng/mL/cc + LD ≥1 cm). Diagnostic ability for PCa and clinical significant PCa (csPCa) was evaluated by PSAD and LD. Results: PSAD ≥0.15 ng/mL/cc (OR = 6; 95% Cl = 2.847–12.647; p < 0.001), LD ≥1 cm (OR = 7.341; 95% confidence interval [CI] = 2.91–18.52; p < 0.001), and combination of PSAD ≥0.15 ng/mL/cc and LD ≥1 cm (OR = 10.023; 95% CI = 4.32–23.252; p < 0.001) were associated with PCa detection rates. The most sensitivity, specificity, negative, and positive predictive values were found in PSAD ≥0.15 ng/mL/cc + LD ≥1 cm group for both PCa and csPCa detection (48.8%, 92%, 85.2%, and 65.6% for any PCa detection; 66.7%, 85.2%, 97.3%, and 24.2% for csPCa detection, respectively). Conclusion: The presence of PSAD ≥0.15 ng/mL/cc or LD ≥1 cm in mpMRI of patients with PI-RADS 3 lesions is associated significantly with the finding of PCa and particularly with the detection of csPCa.

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“…In an elegant study, Alberts et al . has addressed these issues by allowing pathologists to blindly review biopsies with GS ≤6 and fatal cancer in the ERSPC cohort, together with other biopsies of non‐fatal cancer . They confirmed that the ISUP 2014 grading better predicts fatal disease, as 53% of fatal cancers were upgraded at biopsy review using contemporary criteria.…”

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confidence: 92%

Editorial Comment to Biopsy undergrading in men with Gleason score 6 and fatal prostate cancer in the European Randomized study of Screening for Prostate Cancer Rotterdam

2017

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24 Kvale R, Moller B, Wahlqvist R et al. Concordance between Gleason scores of needle biopsies and radical prostatectomy specimens: a population-based study. BJU Int. 2009; 103: 1647-54. 25 Schoots IG, Petrides N, Giganti F et al. Magnetic resonance imaging in active surveillance of prostate cancer: a systematic review. Eur. Urol. 2015; 67: 627-36. 26 Griffiths DF, Melia J, McWilliam LJ et al. A study of Gleason score interpretation in different groups of UK pathologists; techniques for improving reproducibility. Histopathology 2006; 48: 655-62. 27 Melia J, Moseley R, Ball RY et al. A UK-based investigation of inter-and intra-observer reproducibility of Gleason grading of prostatic biopsies.

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Biopsy undergrading in men with Gleason score 6 and fatal prostate cancer in the European Randomized study of Screening for Prostate Cancer Rotterdam

Cited by 6 publications

References 27 publications

Aggressive Cancer Behavior of Latent Gleason Pattern 5 in Prostatectomy Specimens

Aggressive Cancer Behavior of Latent Gleason Pattern 5 in Prostatectomy Specimens

The Value of Prostate-Specific Antigen Density in Combination with Lesion Diameter for the Accuracy of Prostate Cancer Prediction in Prostate Imaging-Reporting and Data System 3 Prostate Lesions

Editorial Comment to Biopsy undergrading in men with Gleason score 6 and fatal prostate cancer in the European Randomized study of Screening for Prostate Cancer Rotterdam

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