Weighted Gleason Grade Group (WGGG): A new prostate cancer biopsy reporting system with prognostic potential

Waingankar, Nikhil; Martini, Alberto; Griffiths, Luke; Shah, Paras; Paulucci, David; Kotamarti, Srinath; Gul, Zeynep; Elmasri, Matthew; Yaskiv, Oksana; Haines, Kenneth; Lerner, Seth P.; Vira, Manish; Kavoussi, Louis R.; Tewari, Ashutosh; Kapoor, Deepak A.; Olsson, Carl A.

doi:10.1016/j.urolonc.2019.10.009

Cited by 3 publications

(5 citation statements)

References 15 publications

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“…The incidence of SVI seemed to be heterogeneous, ranging from 3% to 17.6% in recent studies (1-5). In our cohort, the rate of SVI was 11.5%, which is consistent with the rate reported in recent literature which the median PSA level of the patients (5.9-7.8 ng/mL) is similar with ours (7.51 ng/mL) (3)(4)(5).…”

Section: Discussionsupporting

confidence: 92%

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Predictive model containing PI-RADS v2 score for postoperative seminal vesicle invasion among prostate cancer patients

Wang¹,

Ruan²,

He³

et al. 2021

Transl Androl Urol

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Background: Seminal vesicle invasion (SVI) is considered to be one of most adverse prognostic findings in prostate cancer, affecting the biochemical progression-free survival and disease-specific survival. Multiparametric magnetic resonance imaging (mpMRI) has shown excellent specificity in diagnosis of SVI, but with poor sensitivity. The aim of this study is to create a model that includes the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) score to predict postoperative SVI in patients without SVI on preoperative mpMRI. Methods: A total of 262 prostate cancer patients without SVI on preoperative mpMRI who underwent radical prostatectomy (RP) at our institution from January 2012 to July 2019 were enrolled retrospectively.The prostate-specific antigen levels in all patients were <10 ng/mL. Univariate and multivariate logistic regression analyses were used to assess factors associated with SVI, including the PI-RADS v2 score. A regression coefficient-based model was built for predicting SVI. The receiver operating characteristic curve was used to assess the performance of the model.Results: SVI was reported on the RP specimens in 30 patients (11.5%). The univariate and multivariate analyses revealed that biopsy Gleason grade group (GGG) and the PI-RADS v2 score were significant independent predictors of SVI (all P<0.05). The area under the curve of the model was 0.746 (P<0.001).The PI-RADS v2 score <4 and Gleason grade <8 yielded only a 1.8% incidence of SVI with a high negative predictive value of 98.2% (95% CI, 93.0-99.6%). Conclusions:The PI-RADS v2 score <4 in prostate cancer patients with prostate-specific antigen level <10 ng/mL is associated with a very low risk of SVI. A model based on biopsy Gleason grade and PI-RADS v2 score may help to predict SVI and serve as a tool for the urologists to make surgical plans.

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Section: Discussionsupporting

confidence: 92%

“…The incidence of seminal vesicle invasion (SVI) has decreased over time because of the application of serum prostate specific antigen (PSA) for prostate cancer screening, and the prevalence of SVI in a contemporary surgical series was 3-17.6% (1)(2)(3)(4)(5). SVI is a well-established indicator of adverse prognosis.…”

Section: Introductionmentioning

confidence: 99%

Predictive model containing PI-RADS v2 score for postoperative seminal vesicle invasion among prostate cancer patients

Wang¹,

Ruan²,

He³

et al. 2021

Transl Androl Urol

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“…Is there an optimized GG for better prediction, leading to more accurate treatment? Waingankar et al 28 proposed that the weighted Gleason grade group (WGGG = GGG + [GGG × %Ca/core]) is a novel scoring system. This study explored the possibility that a higher volume of cancer per core would represent a more aggressive disease.…”

Section: Discussionmentioning

confidence: 99%

“…Is there an optimized GG for better prediction, leading to more accurate treatment? Waingankar et al 28 proposed that the weighted As shown in Table 2, agreement (47.2%) and weighted κ coefficient (0.43) of gGG remained inadequate with RP GG. The analysis of SB (Table 3) and TB (Table 4) showed that mGG had the best prediction (agreement 55%, weighted κ 0.46) for SB needles, while lGG had the best prediction (agreement 56.8%, weighted κ 0.43) for TB needles.…”

Section: Meanmentioning

confidence: 99%

Optimized grade group for reporting prostate cancer grade in systematic and MRI‐targeted biopsies

Shen

et al. 2022

The Prostate

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Purpose: To explore an optimized grade group (oGG) criterion from systematic biopsies (SB) and targeted biopsies (TB) and offer a better prediction of radical prostatectomy (RP) grade group (GG).Methods: Positive needles were collected from 146 patients who underwent SB + TB followed by RP. The grade was assigned for two different kinds of biopsies with five GG criteria: (1) global GG (gGG); (2) most common GG (most common GG from SB + TB, mGG); (3) highest GG (highest numerical GG from SB + TB, hGG); (4) largest volume/linear length cancer GG (defined as GG from the SB + TB with the largest length of cancer in a needle, lGG). These biopsy grades were compared (equivalence, upgrade, or downgrade) with the final grade of the RP lesion, using weighted κ coefficients; (5) Then the best agreement of the (2) (3) (4) grading scores from SB or TB was combined to introduce an oGG.Results: In this study, gGG showed generally poor agreement (47.2%) with RP GG (weighted κ: 0.43). Using the three criteria (mGG, hGG, and lGG) of SB, mGG had the best agreement (55.5%, weighted κ: 0.46), while hGG and lGG had a lower agreement (48.6% and 48.6%, weighted κ: 0.42 and 0.38). Using the three criteria (mGG, hGG and lGG) of TB: lGG had the best agreement (56.8%, weighted κ: 0.43), while mGG and hGG had lower agreement (50.0% and 49.3%, weighted κ: 0.40 and 0.40); Then oGG was generated (higher GG between mGG of SB and lGG of TB) and the agreement of oGG increased to 59.6% and weighted κ was 0.49. Additionally, oGG had a lower upgrade rate than gGG, while the downgrade rate remained unchanged.Conclusions: oGG showed better agreement with RP GG than gGG. oGG had a lower upgrade rate than gGG, while downgrade rate remained unchanged.

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“…High biopsy Gleason grade group (GGG) has been shown to be significantly associated with AP [ 20 , 21 ]. In multivariate analysis, biopsy GGG (4 or 5), PSA, and pelvic inflammation (with and without hernia mesh) predicted AP ( p ≤ 0.05) ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

Association between Incidental Pelvic Inflammation and Aggressive Prostate Cancer

Chakravarty

Ratnani

Huang

et al. 2022

Cancers

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The impact of pelvic inflammation on prostate cancer (PCa) biology and aggressive phenotype has never been studied. Our study objective was to evaluate the role of pelvic inflammation on PCa aggressiveness and its association with clinical outcomes in patients following radical prostatectomy (RP). This study has been conducted on a retrospective single-institutional consecutive cohort of 2278 patients who underwent robot-assisted laparoscopic prostatectomy (RALP) between 01/2013 and 10/2019. Data from 2085 patients were analyzed to study the association between pelvic inflammation and adverse pathology (AP), defined as Gleason Grade Group (GGG) > 2 and ≥ pT3 stage, at resection. In a subset of 1997 patients, the association between pelvic inflammation and biochemical recurrence (BCR) was studied. Alteration in tumor transcriptome and inflammatory markers in patients with and without pelvic inflammation were studied using microarray analysis, immunohistochemistry, and culture supernatants derived from inflamed sites used in functional assays. Changes in blood inflammatory markers in the study cohort were analyzed by O-link. In univariate analyses, pelvic inflammation emerged as a significant predictor of AP. Multivariate cox proportional-hazards regression analyses showed that high pelvic inflammation with pT3 stage and positive surgical margins significantly affected the time to BCR (p ≤ 0.05). PCa patients with high inflammation had elevated levels of pro-inflammatory cytokines in their tissues and in blood. Genes involved in epithelial-to-mesenchymal transition (EMT) and DNA damage response were upregulated in patients with pelvic inflammation. Attenuation of STAT and IL-6 signaling decreased tumor driving properties of conditioned medium from inflamed sites. Pelvic inflammation exacerbates the progression of prostate cancer and drives an aggressive phenotype.

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Weighted Gleason Grade Group (WGGG): A new prostate cancer biopsy reporting system with prognostic potential

Cited by 3 publications

References 15 publications

Predictive model containing PI-RADS v2 score for postoperative seminal vesicle invasion among prostate cancer patients

Predictive model containing PI-RADS v2 score for postoperative seminal vesicle invasion among prostate cancer patients

Optimized grade group for reporting prostate cancer grade in systematic and MRI‐targeted biopsies

Association between Incidental Pelvic Inflammation and Aggressive Prostate Cancer

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