- Title
- Percentage grade 4 tumour predicts outcome for prostate adenocarcinoma in needle biopsies from patients with advanced disease: 10-year data from the TROG 03.04 RADAR trial
- Creator
- Delahunt, B.; Steigler, A.; Oldmeadow, C.; Samaratunga, H.; Spry, N. A.; Thunders, M. C.; Hondermarck, H.; Denham, J. W.; Atkinson, C.; Christie, D.; Duchesne, G.; Egevad, L.; Joseph, D.; Kenwright, D. N.; Matthews, J.; Murray, J. D.
- Relation
- Pathology Vol. 54, Issue 1, p. 49-54
- Publisher Link
- http://dx.doi.org/10.1016/j.pathol.2021.11.004
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2022
- Description
- Previous reports have shown that quantification of high tumour grade is of prognostic significance for patients with prostate cancer. In particular, percent Gleason pattern 4 (GP4) has been shown to predict outcome in several studies, although conflicting results have also been reported. A major issue with these studies is that they rely on surrogate markers of outcome rather than patient survival. We have investigated the prognostic predictive value of quantifying GP4 in a series of prostatic biopsies containing Gleason score 3+4=7 and 4+3=7 tumours. It was found that the length of GP4 tumour determined from the measurement of all biopsy cores from a single patient, percent GP4 present and absolute GP4 were all significantly associated with distant progression of tumour, all-cause mortality and cancer-specific mortality over a 10-year follow-up period. Assessment of the relative prognostic significance showed that these parameters outperformed division of cases according to Gleason score (3+4=7 versus 4+3=7). International Society of Urological Pathology (ISUP) Grade Groups currently divide these tumours, according to Gleason grading guidelines, into grade 2 (3+4=7) and grade 3 (4+3=7). Our results indicate that this simple classification results in the loss of important prognostic information. In view of this we would recommend that ISUP Grade Groups 2 and 3 be amalgamated as grade 2 tumour with the percentage of GP4 carcinoma being appended to the final grade, e.g., 3+4=7 carcinoma with 40% pattern 4 tumour would be classified as ISUP Grade Group 2 (40%).
- Subject
- prostate adenocarcinoma; modified gleason grade Gleason pattern 4; international society of urological pathology grade group; prognosis; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1465725
- Identifier
- uon:47360
- Identifier
- ISSN:0031-3025
- Language
- eng
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