Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
Already Have An Account? Log in Now
Association of Gleason Pattern 4 Length With Oncological Outcomes in Men With Grade Group 2 Prostate Cancer
TAKE-HOME MESSAGE
- This study investigated the association between the Gleason pattern 4 (GP4) quantification methods and the postprostatectomy oncological outcomes in 457 patients with grade group 2 prostate cancer. The cohort demonstrated a 3-year biochemical recurrence–free survival probability of 85%. Multivariable analysis showed that the maximum %GP4, overall %GP4, total GP4 length, and total GP4 length in the highest volume core were associated with biochemical recurrence.
-
These results support the addition of GP4 quantification methods to the currently used prostate cancer risk–prediction models that rely on measuring the ratio of GP3 to GP4. Further research is required regarding whether GP4 quantification methods can be used as objective measurement tools for identifying disease progression.
- Written by
-
John T. Wei MD, MS
abstract
This abstract is available on the publisher's site.
Access this abstract nowINTRODUCTION
Gleason Score 7 prostate cancer comprises a wide spectrum of disease risk, and precise sub-stratification is paramount. Our group previously demonstrated that the total length of Gleason pattern 4 (GP4) is a better predictor than %GP4 for adverse pathologic outcomes at radical prostatectomy. We aimed to determine the association of GP4 length on prostate biopsy with post-prostatectomy oncologic outcomes.
METHODS
We compared four GP4 quantification methods including: maximum %GP4 in any single core, overall %GP4, total length GP4 (mm) across all cores, and length GP4 (mm) in the highest volume core, for prediction of biochemical recurrence-free survival after radical prostatectomy using multivariable Cox proportional hazards regression.
RESULTS
A total of 457 men with Grade Group 2 prostate cancer on biopsy subsequently underwent radical prostatectomy. The 3-year biochemical recurrence-free survival probability was 85% (95% CI 81-88%). On multivariable analysis, all four GP4 quantification methods were associated with BCR -maximum %GP4 (HR=1.30; 95% CI 1.07-1.59; p=0.009), overall %GP4 (HR=1.61; 95% CI 1.21-2.15; p=0.001), total length GP4 (HR=2.48; 95% CI 1.36-4.52; p=0.003), and length GP4 in highest core (HR=1.32; 95% CI 1.11-1.57; p=0.001). However, we were unable to identify differences between methods of quantification with a relatively low event rate.
CONCLUSIONS
These findings support further studies on GP4 quantification in addition to the ratio of GP3 and GP4 to classify prostate cancer risk. Research should also be conducted on whether GP4 quantification could provide a surrogate endpoint for disease progression for trials in active surveillance.
Additional Info
Oncologic Outcomes of Total Length Gleason Pattern 4 on Biopsy in Men with Grade Group 2 Prostate Cancer
J Urol 2022 Apr 01;[EPub Ahead of Print], M Perera, MJ Assel, NE Benfante, AJ Vickers, VE Reuter, S Carlsson, V Laudone, KA Touijer, JA Eastham, PT Scardino, SW Fine, B EhdaieFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Advanced Prostate Cancer Center of Excellence
Visit our Advanced Prostate Cancer Center of Excellence for additional, in-depth coverage.