ISUP Group 4 - a Homogenous Group of Prostate Cancers?

Pathology Oncology Research : POR
Thomas Chengxuan LuMichael O'Callaghan

Abstract

The International Society of Urological Pathology (ISUP) and the World Health Organisation have adopted a five-tiered prognostic grade group for prostate cancer in 2014. Grade group 4 is comprised of Gleason patterns 4 + 4, 3 + 5 and 5 + 3. Recent articles have suggested heterogeneity in their prognostic outcomes. We aimed to determine whether there was a difference in mortality outcomes within the ISUP 4 grouping, as identified on needle biopsy. A total of 4080 men who were diagnosed with non-metastatic (N0 M0) prostate cancer on biopsy with Gleason scores of 7, 8 and 9 were included. Multi-variable Cox Regression and Fine and Grey competing risk analysis were used to determine the All-Cause Mortality (ACM) and the Prostate Cancer Specific Mortality (PCSM) as a function of Gleason Scores (Gleason 3 + 4, 4 + 3, 4 + 4, 3 + 5/5 + 3, 9). Gleason score 4 + 4 was utilized as the referent. The 60 months' prostate cancer specific mortality with Gleason patterns 4 + 4 and 3 + 5/5 + 3 were 17% and 20% respectively (P < 0.01). Patients with 3 + 5/5 + 3 disease, had no statistically significant difference in the ACM (adjusted hazard ratio [aHR] 0.99, 95% confidence interval [Cl] 0.68-1.4, p = 0.99) and PCSM risk (aHR 0.77, 95% Cl 0.47-1.2...Continue Reading

References

Apr 16, 2011·International Journal of Radiation Oncology, Biology, Physics·Aaron SabolchDaniel A Hamstra
May 9, 2014·The Lancet Oncology·Laura J EssermanSudhir Srivastava
Jul 15, 2015·European Urology·Jonathan I EpsteinEric A Klein
Jul 25, 2015·BJU International·Brandon A MahalPaul L Nguyen
Sep 22, 2015·European Urology·Mai Anh HuynhAnthony V D'Amico
Jun 7, 2016·The Journal of Urology·Nicholas Harding-JacksonKenneth A Iczkowski

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Citations

Jul 21, 2020·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Eva HollemansGeert J L H van Leenders
Mar 16, 2019·Pathology Oncology Research : POR·Thomas Chengxuan LuMichael O'Callaghan
Jun 27, 2020·Archives of Pathology & Laboratory Medicine·Jonathan I EpsteinKiril Trpkov

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Methods Mentioned

BETA
biopsy

Software Mentioned

STATA
R

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