The impact of the 2005 International Society of Urological Pathology consensus guidelines on Gleason grading - a matched-pair analysis

BJU International
Kasper Drimer BergKlaus Brasso

Abstract

To investigate whether the International Society of Urological Pathology (ISUP) 2005 revision of the Gleason grading system has influenced the risk of biochemical recurrence (BCR) after radical prostatectomy (RP), as the new guideline implies that some prostate cancers previously graded as Gleason score 6 (3 + 3) are now considered as 7 (3 + 4). A matched-pair analysis was conducted. In all, 215 patients with Gleason score 6 or 7 (3 + 4) prostate cancer on biopsy who underwent RP before 31 December 2005 (pre-ISUP group), were matched 1:1 by biopsy Gleason score, clinical tumour category, PSA level, and margin status to patients undergoing RP between 1 January 2008 and 31 December 2011 (post-ISUP group). Patients were followed until BCR defined as a PSA level of ≥0.2 ng/mL. Risk of BCR was analysed in a competing-risk model. The median follow-up was 9.5 years in the pre-ISUP group and 4.8 years in the post-ISUP group. The 5-year cumulative incidences of BCR were 34.0% and 13.9% in the pre-ISUP and post-ISUP groups, respectively (P < 0.001). The difference in cumulative incidence applied to both patients with Gleason score 6 (P < 0.001) and 7 (3 + 4) (P = 0.004). There was no difference in the 5-year cumulative incidence of BCR b...Continue Reading

References

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Citations

Aug 18, 2016·Nature Reviews. Urology·Saiful MiahMark Emberton
Aug 8, 2017·Asian Journal of Andrology·Silvia GasparriniRodolfo Montironi
Dec 11, 2019·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·Rolf ReiterDieter Klatt
Jun 17, 2016·Current Opinion in Urology·Cristina Magi-GalluzziJonathan I Epstein
Jun 13, 2020·BJU International·Anirudh TomerUNKNOWN Movember Foundation’s Global Action Plan Prostate Cancer Active Surveillance (GAP3) consortium
Nov 16, 2019·Archives of Pathology & Laboratory Medicine·Chen Yang, Peter A Humphrey
Sep 30, 2017·Scandinavian Journal of Urology·Mathias ThostrupKlaus Brasso
Aug 2, 2017·Scandinavian Journal of Urology·Sorel KurbegovicMartin Andreas Røder
Oct 21, 2020·American Journal of Clinical Pathology·Gregory P SwansonMichael R Hermans

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