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Evaluation of Gleason Grade Group 5 in a Contemporary Prostate Cancer Grading System and Literature Review.

Abstract：

INTRODUCTION:The aim of this study was to validate contemporary grading systems, in particular, the Gleason grade group (GGG) 5. PATIENTS AND METHODS:We retrospectively reviewed the clinicopathologic data of 176 patients who underwent radical prostatectomy and whose pathologic results were GGG 4 or 5. The endpoints were biochemical recurrence (BCR) and castration-resistant prostate cancer (CRPC). RESULTS:The GGG 4 group was composed of 69 patients. The GGG 5 group consisted of 78 patients with GS 4+5 and 29 patients with GS 5+4 or higher. The 5-year BCR-free survival rates for men with GGG 4, GS 4+5, and GS 5+4 or higher were 59%, 54%, and 20%, respectively, and the 5-year CRPC-free survival rates were 98%, 100%, and 88%, respectively. Both the BCR- and CRPC-free survival rates were significantly higher in GS 4+5 than in GS 5+4 or higher (P < .001 and P = .002, respectively), but there were no significant differences between GGG 4 and GS 4+5 (P = .702 and P = .803, respectively). The multivariate analysis demonstrated that GS 5+4 or higher (hazard ratio, 3.4; P = .002) and lymphovascular invasion (hazard ratio, 3.4; P < .001) greatly affected BCR. CONCLUSION:Our follow-up study revealed that men with GS 4+5 and those with GGG 4 had a similar prognosis. However, there was a significant discrepancy in prognosis between GS 4+5 and GS 5+4 or higher. This suggested that GGG 4 and 5 in the contemporary prostate cancer grading system should be reviewed. Furthermore, lymphovascular invasion may be useful to subgroup these pathologically high-risk patients.

journal_name

Clin Genitourin Cancer

journal_title

Clinical genitourinary cancer

authors

Kamitani R,Matsumoto K,Kosaka T,Takeda T,Hashiguchi A,Tanaka N,Morita S,Mizuno R,Shinojima T,Asanuma H,Oya M

doi

10.1016/j.clgc.2020.08.001

subject

Has Abstract

pub_date

2020-08-07 00:00:00

eissn

1558-7673

issn

1938-0682

pii

S1558-7673(20)30190-7

pub_type

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