Percentage of Gleason pattern 4 and tumor volume predict adverse pathological stage and margin status at radical prostatectomy in grade Group 2 and grade Group 3 prostate cancers

The Prostate ◽  
2021 ◽  
Author(s):  
Oleksii A. Iakymenko ◽  
Isabella Lugo ◽  
Laurence M. Briski ◽  
Ivan Nemov ◽  
Sanoj Punnen ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Tumor Volume ◽  
Margin Status ◽  
Pathological Stage ◽  
Grade Group ◽  
Gleason Pattern ◽  
Group 3 ◽  
Group 2 ◽  
Prostate Cancers

The impact of tertiary Gleason pattern 5 in the grade group system on recurrence following radical prostatectomy in patients with prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 44-44
Author(s):  
Masashi Kato ◽  
Toyonori Tsuzuki ◽  
Ryo Ishida ◽  
Tohru Kimura ◽  
Osamu Kamihira ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Grade Group ◽  
Group System ◽  
Gleason Pattern ◽  
Group 4 ◽  
Significant Difference ◽  
Psa Progression ◽  
Group 3 ◽  
Group 2

44 Background: The current ISUP/WHO grade group system classified the Gleason grade into five groups. Although presence of tertiary Gleason pattern 5 (tG5) reported to be related with unfavorable tumor characteristic, only a few data is available about influences on the grade group system of tG5 so far. In this study, we evaluated the effect of tG5 on recurrence following radical prostatectomy in patients with prostate cancer. Methods: We retrospectively evaluated 1,020 patients with prostate cancer who underwent radical prostatectomy without neoadjuvant therapy at the hospitals that the authors were affiliated with between 2005 and 2013. After excluding the patients with missing data or slides, 1000 patients were enrolled in this study. All prostatectomy specimen slides were reviewed by a single genitourinary pathologist according to ISUP 2014. Recurrence following radical prostatectomy was defined according to European Association of Urology guidelines. The endpoint was defined as an increase in PSA level. Results: Patient median age was 67 years (range 49–77 years). The median serum PSA was 6.9 ng/mL (range 0.4–82 ng/mL). The median follow-up period was 69 months (range 0.7–134 months). All the patients showed Group1:163 cases (16.3%), Group2: 436 (43.6%), Group 2 with tG5: 54 (5.4%), Group 3:121 (12.1%), Group 3 with tG5: 89 (8.9%), Group 4: 39 (3.9%), and Group 5: 98 (9.8%). PSA progression-free survival was significantly different among the five groups (Group1-5) (p = 0.0001). As concerning tG5, it showed significant difference between Group 2 and Group 2 with tG5 by using log rank test (p < 0.0001). Similarly, there was significant difference between Group 3 and Group 3 with tG5 (p = 0.001). On the other hand, there was no difference between Group 2 with tG5 and Group 3 (p = 0.916), and in the same way, no difference between Group 3 with tG5 and Group 4 (p = 0.854). Conclusions: The Presence of tG5 on the grade group system increase PSA progression following radical prostatectomy in patients with prostate cancer. Especially, Group 2 and 3 showed upgrade by presence of tG5. Integrating tG5 into the grade group system will improve the accuracy of patient outcome predictions.

The impact of intraductal carcinoma of the prostate on the grade group system.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 34-34
Author(s):  
Masashi Kato ◽  
Akiyuki Yamamoto ◽  
Ryo Ishida ◽  
Tohru Kimura ◽  
Tomoyasu Sano ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Surgical Margin ◽  
Grade Group ◽  
Group System ◽  
Carcinoma Of The Prostate ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2

34 Background: The 2014 International Society of Urological Pathology (ISUP) and WHO 2016 classifications proposed a new grade group system for prostate cancer. Intraductal carcinoma of the prostate (IDC-P) is newly recognized on them and is reported to be strongly associated with high-grade and high-volume invasive prostate cancer. Although the presence of the IDC-P influences biochemical failure in radical prostatectomy patients, no data are available regarding the significance of IDC-P in integrating to the classification grade group system. The aim of this study is to enhance the utility of grade group system integrating into the presence of IDC-P. Methods: We retrospectively evaluated 1019 patients with prostate cancer who underwent radical prostatectomy without neoadjuvant or adjuvant therapy at the hospitals that the authors were affiliated with between 2005 and 2013. Data on age, PSA level at diagnosis, clinical T stage (cT), pathological T stage (pT), presence of Gleason pattern 5 (GP5), presence of IDC-P, and surgical margin status were analyzed to predict PSA recurrence after prostatectomy. Results: The median patient age was 67 (range, 45–80) years. The median initial PSA was 6.8 ng/ml (range, 0.4–82 ng/ml). The median follow-up period was 82 (range, 0.7–148) months. IDC-P was detected in 157 patients (15.4%). Among these patients, IDC-P positive rate increased correlated with upgrading. The grade group were as follows: Group 1 without IDC-P, 16.0% (n=163); Group 2 without IDC-P, 46.1% (n=470); Group 3 without IDC-P, 15.7% (n=160); Group 4 without IDC-P, 2.6% (n=27); and Group 5 without IDC-P, 4.1% (n=42); Group 2 with IDC-P, 2.9% (n=29); Group 345 with IDC-P, 12.6% [n=128; Group 3 (n=60); Group 4 (n=13); Group 5 (n=55)] Group 3, 4, and 5 with IDC-P showed a significantly worse prognosis than any other groups without IDC-P and Group 2 with IDC-P (p<.0001). In a multivariate analysis, integrating IDC-P into ISUP Grade, PSA level at diagnosis, and surgical margin status significantly predicted the prognosis (P < .0001). Conclusions: Integrating the presence of IDC-P into the grade group system will improve the accuracy of patients’ outcome prediction.

Biochemical Recurrence After Radical Prostatectomy: Multiplicative Interaction Between Surgical Margin Status and Pathological Stage

2010 ◽  
Vol 184 (4) ◽  
pp. 1341-1346 ◽  
Author(s):  
Lars Budäus ◽  
Hendrik Isbarn ◽  
Christian Eichelberg ◽  
Giovanni Lughezzani ◽  
Maxine Sun ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Surgical Margin ◽  
Margin Status ◽  
Pathological Stage ◽  
Multiplicative Interaction

scholarly journals MP23-11 PREDICTION OF ADVERSE OUTCOMES AT RADICAL PROSTATECTOMY IN GRADE GROUP 2 AND 3 PROSTATE BIOPSIES USING MACHINE LEARNING

2020 ◽  
Vol 203 ◽  
pp. e342
Author(s):  
Nathan J Paulson* ◽  
Tal Zeevi ◽  
Maria Papademetris ◽  
John A Onofrey ◽  
Preston C Sprenkle ◽  
...  
Keyword(s):  
Machine Learning ◽  
Radical Prostatectomy ◽  
Adverse Outcomes ◽  
Grade Group ◽  
Prostate Biopsies ◽  
Group 2

Biochemical outcome of small volume or insignificant prostate cancer treated with radical prostatectomy.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 279-279
Author(s):  
Yasuhiro Hashimoto ◽  
Akiko Okamoto ◽  
Atsushi Imai ◽  
Hayato Yamamoto ◽  
Shingo Hatakeyama ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Small Volume ◽  
Tumor Volume ◽  
Specific Antigen ◽  
Rank Test ◽  
Psa Failure ◽  
Significant Difference ◽  
Pre Treatment ◽  
Prostate Cancers

279 Background: We examined biochemical outcome of small volume prostate cancers (<0.5 cc, SVCa), and insignificant prostate cancers (<0.5 cc and Gleason scores <7, InsigCa) treated with radical prostatectomy. Methods: Between April 2000 and May 2011, 609 patients with prostate cancer were treated with radical prostatectomy in Hirosaki University Graduate School of Medicine. Of these, 237 were excluded from analysis because of pre-operative adjuvant treatment. The remaining 372 patients were eligible in the present study. Along with the routine pathological assessment, tumor volume (TV) was assessed in all patients. Biochemical recurrence (BCR) was defined as prostate-specific antigen (PSA) levels of greater than 0.2ng/ml. Results: The median age was 68 (48 to 78) and median pre-treatment PSA was 7.50 ng/ml.Average follow up period was 45.9 month. Mean tumor volume (TV) was 2.16 cc. We investigated 372 patients and found SVCa (<0.5 cc) in 60 patients (16.3%), and InsigCa in 14 patients (3.7%). The five year BCR-free survival rate for TV greater than or equal to 0.5 group and SVCa was 67.3% and 87.1% respectively. A significant difference was seen in the log-rank test between the two groups ( p=0.008). We could not identify BCR in InsigCa patients. Conclusions: Despite the limited number of cases, in our study InsigCa were clinically insignificant but in SVCa group 12.9% patients developed PSA failure after radical prostatectomy. SVCa is not identical to InsigCa. Therefore new biomarker is needed to examine what the prognostic relevance is of SVCa.

scholarly journals Peripancreatic Soft Tissue Involvement: Independent Outcome Predictor in Patients With Resected Pancreatic Adenocarcinoma

2014 ◽  
Vol 99 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Alireza Hamidian Jahromi ◽  
Gazi B. Zibari ◽  
Elnaz Jafarimehr ◽  
Quyen Chu ◽  
Gregory P. Wellman ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Pancreatic Adenocarcinoma ◽  
Cox Regression ◽  
Margin Status ◽  
Cox Regression Analysis ◽  
R1 Resection ◽  
Soft Tissue Involvement ◽  
Group 3 ◽  
Group 2 ◽  
The Impact

Abstract The impact of cancer involving the peripancreatic soft tissue (PST), irrespective of margin status, following a resection of pancreatic adenocarcinoma is not known. The purpose of this study is to determine such an impact on a cohort of patients. Data from 274 patients who underwent pancreatic surgery by our team between 1998 and 2012 was reviewed. Of those 119 patients who had pancreatic resection for adenocarcinoma were retrospectively analyzed. Patients were categorized into 3 groups: Group 1 = R1 resection (N = 39), Group 2 = R0 with involved PST (N = 54), and Group 3 = R0 with uninvolved PST (N = 26). Demographics, operative data, tumor characteristics and overall survival (OS) were evaluated. Operations performed were: Whipple (N = 53), pylorus sparing Whipple (N = 41), total pancreatectomy (N = 11), and other (N = 14). Median OS for Groups 1, 2, and 3 were 8.5 months, 12 months, and 69.6 months respectively (P &lt; 0.001). Tumor size (P = 0.016), margin status (P = 0.006), grade (P = 0.001), stage (P = 0.037), PST status (P &lt; 0.001), complications (P = 0.046), transfusion history (P = 0.003) were all predictors of survival. Cox regression analysis demonstrated that grade (HR = 3.1), PST involvement (HR = 2.7), transfusion requirement (HR = 2.6) and margin status (HR = 2.0) were the only independent predictors of mortality. PST is a novel predictor of poor outcome for patients with resected pancreatic cancer.

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