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: Anika Jain, Lawrence Kim, Manish I. Patel
Format: Article
Language:English
Published: Korean Society for Sexual Medicine and Andrology 2025-07-01
Series:The World Journal of Men's Health
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author Anika Jain
Lawrence Kim
Manish I. Patel
author_facet Anika Jain
Lawrence Kim
Manish I. Patel
author_sort Anika Jain
collection DOAJ
description 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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spelling doaj-art-4066f887aa9e44849be7e9879c726ffc2025-08-20T03:23:43ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902025-07-0143359560210.5534/wjmh.230216Pathological Assessment of Men with Grade Group 2 Prostate CancerAnika Jain0https://orcid.org/0000-0002-5649-8157Lawrence Kim1https://orcid.org/0000-0002-4732-0082Manish I. Patel2https://orcid.org/0000-0003-1409-9171Department of Urology, Western Sydney Local District, Granville, NSW, AustraliaDepartment of Urology, Western Sydney Local District, Granville, NSW, AustraliaDepartment of Urology, Western Sydney Local District, Granville, NSW, AustraliaPurpose: 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.active surveillancegrade group 2pathologyprostate cancerprostatic neoplasmswatchful waiting
spellingShingle Anika Jain
Lawrence Kim
Manish I. Patel
Pathological Assessment of Men with Grade Group 2 Prostate Cancer
The World Journal of Men's Health
active surveillance
grade group 2
pathology
prostate cancer
prostatic neoplasms
watchful waiting
title Pathological Assessment of Men with Grade Group 2 Prostate Cancer
title_full Pathological Assessment of Men with Grade Group 2 Prostate Cancer
title_fullStr Pathological Assessment of Men with Grade Group 2 Prostate Cancer
title_full_unstemmed Pathological Assessment of Men with Grade Group 2 Prostate Cancer
title_short Pathological Assessment of Men with Grade Group 2 Prostate Cancer
title_sort pathological assessment of men with grade group 2 prostate cancer
topic active surveillance
grade group 2
pathology
prostate cancer
prostatic neoplasms
watchful waiting
work_keys_str_mv AT anikajain pathologicalassessmentofmenwithgradegroup2prostatecancer
AT lawrencekim pathologicalassessmentofmenwithgradegroup2prostatecancer
AT manishipatel pathologicalassessmentofmenwithgradegroup2prostatecancer