Pathological Assessment of Men with Grade Group 2 Prostate Cancer
Purpose: A variety of treatment options are now available for men with localized prostate cancer (PC); however, there is still debate in determining how and when to intervene for Grade Group (GG) 2 disease. Our study aims to formulate strategies to identify men at risk of upgrading and having adve...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2025-07-01
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| Series: | The World Journal of Men's Health |
| Subjects: | |
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| Summary: | Purpose: A variety of treatment options are now available for men with localized prostate cancer (PC); however, there is still
debate in determining how and when to intervene for Grade Group (GG) 2 disease. Our study aims to formulate strategies to
identify men at risk of upgrading and having adverse pathological outcomes.
Materials and Methods: This retrospective study includes 243 patients with GG2 PC that were treated with radical prostatectomy
between 2015 and 2021. Patients on active surveillance, previous history of prostate biopsy, hormonal and/or radiation
therapy prior to surgery were excluded from this study. A retrospective analysis was conducted using clinicopathological data
obtained from medical records.
Results: Prostate-specific antigen (PSA) and Prostate Imaging Reporting and Data System (PI-RADS) score were statistically
significant variables for risk of upgrading. In men who had presence of composite poor outcomes, PSA, PI-RADS score, presence
of extraprostatic extension and seminal vesical invasion on MRI, number of positive cores, percentage of high grade
(pattern 4/5) on prostate biopsy and Gleason pattern 4 volume on biopsy were all statistically significant variables. Strategy
8 (PI-RADS 5 lesion or percentage high grade [Gleason pattern 4] on prostate biopsy grade >10% or >3 cores positive on
prostate biopsy) had significant association to identifying the highest number of men with upgrading and composite poor
outcomes.
Conclusions: Our study supports the use of strategy 8 in treatment decision making of men with GG2 PC. Further validation
of the use of this strategy is warranted. |
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| ISSN: | 2287-4208 2287-4690 |