New Prostate Cancer Grading System Predicts Long-term Survival Following Surgery for Gleason Score 8–10 Prostate Cancer

Ham, Won Sik; Chalfin, Heather J.; Trock, Bruce J.; Epstein, Jonathan I.; Cheung, Carling; Humphreys, Elizabeth B.; Partin, Alan W.; Han, Misop

doi:10.1016/j.eururo.2016.11.006

Cited by 50 publications

(37 citation statements)

References 26 publications

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“…Ham and coworkers examined mortality outcomes in men who had GG 4 and GG 5 disease diagnosed on either biopsy or RP specimens. The cohort spanned procedures performed between 1984 and 2014 and included 721 men who had original biopsy Gleason scores of 8 to 10 and 1047 men who had original RP Gleason scores of 8 to 10 . Those investigators observed worse PCSM and ACM in men with GG 5 (Gleason score ≥9) compared with GG 4 (Gleason score 8) for both biopsy and RP grading.…”

Section: Discussionmentioning

confidence: 99%

“…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) …”

Section: Introductionmentioning

confidence: 99%

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

Schulman

Howard

Tay

et al. 2017

Cancer

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Schulman

Howard

Tay

et al. 2017

Cancer

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“…10 Having been incorporated into the 2016 World Health Organization classification of urinary tract tumors, 11 several studies demonstrated the prognostic value of the GrGp system when predicting long-term oncological outcomes with regard to biochemical disease progression, metastasis, and cancer-specific survival rates. [12][13][14][15] Furthermore, several studies have indicated that adverse pathologic features on prostatectomy specimens can predict oncological outcome. For example, Imnadze et al demonstrated that for patients with GrGp ≥3 or with extraprostatic extension on the prostatectomy specimen, the risk of 5-year biochemical disease recurrence (BCR) is significantly higher (>40% when compared with patients with a lower GrGp).…”

Section: Another Evaluation By Billis Et Almentioning

confidence: 99%

Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy

Aminsharifi

Schulman

Howard

et al. 2019

Cancer

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BACKGROUND:The current study was performed to evaluate the influence of race on the association between biopsy grade group (GrGp) and the risk of detectable prostate-specific antigen (PSA) and adverse histopathological outcomes after radical prostatectomy (RP). METHODS: Data regarding 4073 men (1344 African American men; 33%) who were treated with RP were categorized based on the 5-tiered GrGp system. Logistic regression was used to test the association between biopsy GrGp and PSA nadir (<0.1 ng/mL) after RP as well as adverse pathological features among all patients and stratified by race. RESULTS: Those patients with a higher biopsy GrGp were found to have lower odds of achieving a PSA nadir <0.1 ng/mL after RP on unadjusted and multivariable analysis (both P < .001). On unadjusted and multivariable analysis, higher GrGp was associated with increased odds of each of the adverse pathological features, namely, GrGp ≥3, extraprostatic extension, seminal vesicle invasion, positive surgical resection margin, and positive lymph nodes (all P < .001). Race had no significant interaction with biopsy GrGp in the prediction of PSA nadir after RP (P = .91) or any adverse pathological features (all P > .06) except positive lymph nodes. When the models were stratified by race, the associations between preoperative biopsy GrGp and having a PSA nadir <0.1 ng/mL, high-grade final pathology, or other adverse histopathologic features were similar in both races except as noted for positive lymph nodes. CONCLUSIONS: Higher preoperative biopsy GrGp is associated with increased odds of adverse histopathological findings as well as lower odds of a PSA nadir <0.1 ng/mL after RP. These associations are largely independent of race, suggesting that GrGp is an accurate tool for risk stratification in both black and white men. Cancer 2019;125:3025-3032.

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“…This new grading system can be used to predict mortality risk after radical prostatectomy for patients with grade groups 4 and 5. Prostatic cancer-specific survival is significantly shorter for patients with grade group 5 than patients with grade group 4 for the biopsy (hazard ratio [HR] = 2.13, 95% confidence interval [CI] = 1.37–3.30) and radical prostatectomy groups (HR = 2.38, 95% CI = 1.74–3.28) [48]. …”

Section: The 2016 Who Classificationmentioning

confidence: 99%

Prostatic cancers: understanding their molecular pathology and the 2016 WHO classification

Inamura

2018

Oncotarget

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Accumulating evidence suggests that prostatic cancers represent a group of histologically and molecularly heterogeneous diseases with variable clinical courses. In accordance with the increased knowledge of their clinicopathologies and genetics, the World Health Organization (WHO) classification of prostatic cancers has been revised. Additionally, recent data on their comprehensive molecular characterization have increased our understanding of the genomic basis of prostatic cancers and enabled us to classify them into subtypes with distinct molecular pathologies and clinical features. Our increased understanding of the molecular pathologies of prostatic cancers has permitted their evolution from a poorly understood, heterogeneous group of diseases with variable clinical courses to characteristic molecular subtypes that allow the implementation of personalized therapies and better patient management. This review provides perspectives on the new 2016 WHO classification of prostatic cancers as well as recent knowledge of their molecular pathologies. The WHO classification of prostatic cancers will require additional revisions to allow for reliable and clinically meaningful cancer diagnoses as a better understanding of their molecular characteristics is obtained.

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New Prostate Cancer Grading System Predicts Long-term Survival Following Surgery for Gleason Score 8–10 Prostate Cancer

Cited by 50 publications

References 26 publications

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

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

Influence of African American race on the association between preoperative biopsy grade group and adverse histopathologic features of radical prostatectomy

Prostatic cancers: understanding their molecular pathology and the 2016 WHO classification

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