SIU-ICUD: Localized Prostate Cancer: Pathological Factors That Influence Outcomes and Management

<b>Background/Objectives:</b> Pathological factors are integral in the risk stratification and management of localized prostate cancer. In recent years, there has been an upsurge of studies that uncovered novel approaches and have refined prognostic factors for prostate cancer in needle...

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Main Authors: Gladell P. Paner, Eva M. Compérat, Samson W. Fine, James G. Kench, Glen Kristiansen, Rajal B. Shah, Steven Christopher Smith, John R. Srigley, Geert J. L. H. van Leenders, Murali Varma, Ming Zhou, Mahul B. Amin
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Société Internationale d’Urologie Journal
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Online Access:https://www.mdpi.com/2563-6499/6/3/41
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author Gladell P. Paner
Eva M. Compérat
Samson W. Fine
James G. Kench
Glen Kristiansen
Rajal B. Shah
Steven Christopher Smith
John R. Srigley
Geert J. L. H. van Leenders
Murali Varma
Ming Zhou
Mahul B. Amin
author_facet Gladell P. Paner
Eva M. Compérat
Samson W. Fine
James G. Kench
Glen Kristiansen
Rajal B. Shah
Steven Christopher Smith
John R. Srigley
Geert J. L. H. van Leenders
Murali Varma
Ming Zhou
Mahul B. Amin
author_sort Gladell P. Paner
collection DOAJ
description <b>Background/Objectives:</b> Pathological factors are integral in the risk stratification and management of localized prostate cancer. In recent years, there has been an upsurge of studies that uncovered novel approaches and have refined prognostic factors for prostate cancer in needle biopsy and radical prostatectomy (RP) specimens. <b>Methods:</b> We conducted a review of literature and summarized the significant recent updates on pathological factors for localized prostate cancer. <b>Results:</b> Innovative factors derived from the traditional Gleason grading, such as the extent of Gleason pattern 4 and presence of cribriform pattern are now recognized to significantly improve discrimination of outcome. The components and rules of Gleason grading themselves underwent modifications, and the subsequent prognostic grouping of the different grades (Grade group) have resulted in enhanced stratification of behavior more meaningful in management decision. The approaches for grade reporting in systematic or targeted needle biopsies and in RP with multifocal cancers are also being optimized. Newer tumor growth pattern-based factors such as intraductal carcinoma and atypical intraductal proliferation can have ramifications in management, especially in the background of low to intermediate risk prostate cancers. Gleason grade considerations in the different post-treatment settings and for de novo and residual prostate cancers with varying treatment effects have also been explicated. Likewise, the application of more traditional factors in tumor extent and perineural invasion in biopsy, or positive surgical margin in RP, have also evolved. <b>Conclusions:</b> Some of these newer pathological factors are now officially recommended in standardized pathology reporting protocols and are applied in the management decision for localized prostate cancer.
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spelling doaj-art-e7e183cf416e40b6872d807801329cfa2025-08-20T03:27:43ZengMDPI AGSociété Internationale d’Urologie Journal2563-64992025-06-01634110.3390/siuj6030041SIU-ICUD: Localized Prostate Cancer: Pathological Factors That Influence Outcomes and ManagementGladell P. Paner0Eva M. Compérat1Samson W. Fine2James G. Kench3Glen Kristiansen4Rajal B. Shah5Steven Christopher Smith6John R. Srigley7Geert J. L. H. van Leenders8Murali Varma9Ming Zhou10Mahul B. Amin11Departments of Pathology and Surgery (Urology), University of Chicago, Chicago, IL 60637, USADepartment of Pathology, University of Vienna, 1010 Vienna, AustriaDepartment of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, AustraliaInstitute of Pathology, University Hospital Bonn, 53127 Bonn, GermanyDivision of Anatomic Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USADepartment of Pathology, Virginia Commonwealth University School of Medicine, Massey Cancer Center, Richmond, VA 23298, USADepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, CanadaDepartment of Pathology, Erasmus MC Cancer Institute, P.O. Box 2040, 3000 CA Rotterdam, The NetherlandsCellular Pathology, University Hospital of Wales, Cardiff CF14 4XW, UKDepartment of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA 02111, USADepartment of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA<b>Background/Objectives:</b> Pathological factors are integral in the risk stratification and management of localized prostate cancer. In recent years, there has been an upsurge of studies that uncovered novel approaches and have refined prognostic factors for prostate cancer in needle biopsy and radical prostatectomy (RP) specimens. <b>Methods:</b> We conducted a review of literature and summarized the significant recent updates on pathological factors for localized prostate cancer. <b>Results:</b> Innovative factors derived from the traditional Gleason grading, such as the extent of Gleason pattern 4 and presence of cribriform pattern are now recognized to significantly improve discrimination of outcome. The components and rules of Gleason grading themselves underwent modifications, and the subsequent prognostic grouping of the different grades (Grade group) have resulted in enhanced stratification of behavior more meaningful in management decision. The approaches for grade reporting in systematic or targeted needle biopsies and in RP with multifocal cancers are also being optimized. Newer tumor growth pattern-based factors such as intraductal carcinoma and atypical intraductal proliferation can have ramifications in management, especially in the background of low to intermediate risk prostate cancers. Gleason grade considerations in the different post-treatment settings and for de novo and residual prostate cancers with varying treatment effects have also been explicated. Likewise, the application of more traditional factors in tumor extent and perineural invasion in biopsy, or positive surgical margin in RP, have also evolved. <b>Conclusions:</b> Some of these newer pathological factors are now officially recommended in standardized pathology reporting protocols and are applied in the management decision for localized prostate cancer.https://www.mdpi.com/2563-6499/6/3/41prostatecancerpathologicalprognosticfactorselements
spellingShingle Gladell P. Paner
Eva M. Compérat
Samson W. Fine
James G. Kench
Glen Kristiansen
Rajal B. Shah
Steven Christopher Smith
John R. Srigley
Geert J. L. H. van Leenders
Murali Varma
Ming Zhou
Mahul B. Amin
SIU-ICUD: Localized Prostate Cancer: Pathological Factors That Influence Outcomes and Management
Société Internationale d’Urologie Journal
prostate
cancer
pathological
prognostic
factors
elements
title SIU-ICUD: Localized Prostate Cancer: Pathological Factors That Influence Outcomes and Management
title_full SIU-ICUD: Localized Prostate Cancer: Pathological Factors That Influence Outcomes and Management
title_fullStr SIU-ICUD: Localized Prostate Cancer: Pathological Factors That Influence Outcomes and Management
title_full_unstemmed SIU-ICUD: Localized Prostate Cancer: Pathological Factors That Influence Outcomes and Management
title_short SIU-ICUD: Localized Prostate Cancer: Pathological Factors That Influence Outcomes and Management
title_sort siu icud localized prostate cancer pathological factors that influence outcomes and management
topic prostate
cancer
pathological
prognostic
factors
elements
url https://www.mdpi.com/2563-6499/6/3/41
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