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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| Format: | Article |
| Language: | English |
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Korean Society for Sexual Medicine and Andrology
2025-07-01
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| 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. |
| format | Article |
| id | doaj-art-4066f887aa9e44849be7e9879c726ffc |
| institution | DOAJ |
| issn | 2287-4208 2287-4690 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Korean Society for Sexual Medicine and Andrology |
| record_format | Article |
| series | The World Journal of Men's Health |
| 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 |