Clinicopathological Analysis of the ISUP Grade Group And Other Parameters in Prostate Cancer: Elucidation of Mutual Impact of the Various Parameters

Abstract

BackgroundProstate cancer has become increasingly common worldwide. Although Grade group (GG) is widely accepted as an indicator of prostate cancer grade, there are malignancies that cannot be defined by GG alone. Moreover, the relationship between GG and other parameters remains unclear. Herein, we aimed to explore the biological characteristics of prostate cancer.MethodsThis study included 299 radical prostatectomy cases. The Chi-square test and analysis of variance were used to analyze the association of GG with binary and continuous variables. We then conducted morphological analyses. Multivariate analyses were performed to extract the data on risk factors for biochemical recurrence (BCR) and lymph node metastasis.ResultsThe lymphatic, venous, perineural, and seminal vesicle invasion rates were 37/299 (12.4%), 25/299 (8.4%), 280/299 (93.6%), and 23/299 (7.7%), respectively. The extraprostatic extension (EPE), positive surgical margin, tertiary Gleason pattern 5, intraductal carcinoma of the prostate gland, and lymph node metastasis rates were 89/299 (29.8%), 106/299 (35.5%), 33/260 (12.7%), 56/299 (18.7%), and 23/299 (7.7%), respectively. As GG increased, various parameters became easier to visualize; however, there were differences between the parameters. Postoperative BCR was observed in 31/242 (12.8%) cases without preoperative hormone therapy; GG2, GG3, GG4, and GG5 accounted for 4, 7, 7, and 13 cases, respectively. Multivariate analyses revealed that GG and tumor diameter were significant risk factors for early BCR, whereas lymphatic invasion, EPE, and seminal vesicle invasion were significant risk factors for lymph node metastasis. For BCR, the odds ratios (ORs) for GG and tumor diameter were 2.253 (95% confidence interval (CI]): 1.297–3.912; P=0.004) and 1.074 (95% CI: 1.011–1.142; P=0.022), respectively. For lymph node metastasis, ORs for the presence of lymphatic invasion, EPE, and seminal vesicle invasion were 7.425 (95% CI: 1.688–22.583; P=0.004), 4.391 (95% CI: 1.037–18.589; P=0.044), and 5.755 (95% CI: 1.308–25.316; P=0.021), respectively.ConclusionsWe summarized various parameters correlating with each GG. Through multivariate analyses, we established the independent risk factors for early BCR and lymph node metastasis. In addition to GG, other important indices of malignancy were determined and weighted to provide a basis for future investigations.

The survival benefit of different lymph node yields in radical prostatectomy for pN1M0 prostate cancer patients: Implications from a population-based study

“…Imaging results such as CT/PET-CT and multiparametric MRI/PET-MRI had low sensitivity in identifying lymph node metastases ( 24 , 25 ). Nomograms had been built for predicting lymph node metastases ( 2 , 6 ); these tools also mainly relied on Gleason score and T stage, and we found that the two factors had an impact on the survival benefit of LND, and that extended LND was more likely to remove occult lymph node metastases, as higher Gleason score and T stage were risk factors for lymph node metastasis ( 26 – 28 ). We would like to point out that this study found Gleason score >8 and T stage >T3a was an indication for more lymph node yield.…”

Esophageal Mucoepidermoid Carcinoma: A Review of 58 Cases

“…Second, many other prognostic factors, such as the lymphovascular invasion, has been known to be a poor prognostic factor for many cancers. However, we did not recorded the information of these factors in this study ( 31 ). Third, we could not promote a multidisciplinary treatment strategy for EMEC in this study, especially for advanced disease.…”

Prognostic Impact of Lymphatic Invasion in Patients with High-Risk Prostate Cancer after Robot-Assisted Radical Prostatectomy and Extended Lymph Node Dissection: A Single-Institution Prospective Cohort Study

“…In a study that included 299 radical prostatectomy cases, Okubo et al showed that lymphatic invasion was independently associated with lymph node metastasis, whereas venous invasion was not. They recommended that lymphatic and venous invasion should be evaluated separately rather than being combined into the category of LVI [ 37 ]. Wilczak et al retrospectively analyzed pathological and clinical data from 14,528 consecutive patients who underwent radical prostatectomy and examined of the prognostic value of lymphatic invasion [ 21 ].…”