Independent validation of the prognostic capacity of the ISUP prostate cancer grade grouping system for radiation treated patients with long-term follow-up

Abstract

In a large independent radiotherapy cohort with long-term follow-up, we have validated the bRFS benefit of the proposed five-tier grade grouping system. Furthermore, we have demonstrated that the system is highly prognostic for DMFS and PCSS. Grade group 5 had markedly worse outcomes for all end points, and future work is necessary to improve outcomes in these patients.

Population-Based Validation of the 2014 ISUP Gleason Grade Groups in Patients Treated With Radical Prostatectomy, Brachytherapy, External Beam Radiation, or no Local Treatment

“…Taken together, despite lack of unanimity, all available studies that addressed discriminant properties of GGG relative to TGG, agree that GGG is better than TGG, when either absolute or relative rates are compared . Moreover, the results are relatively generalizable, regardless of examined endpoints: BCR, CR, or PCSM.…”

“…Since then, GGG was externally validated in one multi‐institutional study , two European and one North American population‐based cohorts , as well as in two single center cohorts . In most studies, the primary outcome was BCR: two studies (n = 847 and 988) that relied on needle biopsy specimens in the contexts of radiotherapy and conservative management used PCSM as endpoint .…”

“…Since then, GGG was externally validated in one multi-institutional study [12], two European and one North American population-based cohorts [7,9,17], as well as in two single center cohorts [6,18]. In most studies, the primary outcome was BCR: two studies (n ¼ 847 and 988) that relied on needle biopsy specimens in the contexts of radiotherapy and conservative management used PCSM as endpoint [6,7]. Parallel to our work, another report, published by He et al [9] reported on 331,320 PCa patients that underwent RP, RT, or other treatments between 2006 and 2012 from the SEER database.…”

Prostat Kanser Patolojisi

“…Grade grupları, standart Gleason skorlamasıyla karşılaştırıldığında daha iyi bir prognostik risk ayrımı ortaya koymaktadır [31,32]. Bu grupların prognostik değeri, bir dizi çalış-mayla doğrulanmıştır [31][32][33] ve sistem için genomik korelasyon ve moleküler destek de vardır [34].…”

“…Bu grupların prognostik değeri, bir dizi çalış-mayla doğrulanmıştır [31][32][33] ve sistem için genomik korelasyon ve moleküler destek de vardır [34]. Bu kullanımın bir diğer faydası, 1'den 10'a kadar olan skalada intermediyer derece gibi duran Gleason skor 6 kanserin, 1'den 5'e kadar olan gruplamada en düşük kategoriye (1/5) yerleştirilmiş olmasıdır; böy-lece doktorlar ve hastalara skor 6 prostat kanserinin nispeten selim doğasını yansıtmak mümkün olmaktadır [20].…”