scholarly journals How Much Reliable Is the Current Belief on Grade Group 1 Prostate Cancer?

2021 ◽  
Vol 27 ◽  
Author(s):  
Mun Su Chung ◽  
Yeong Jin Choi ◽  
Young Sub Lee ◽  
Byung Il Yoon ◽  
U-Syn Ha
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Treatment Options ◽  
Clinicopathological Characteristics ◽  
Pathological Features ◽  
Grade Group ◽  
Asian Populations ◽  
Current Belief ◽  
Extraprostatic Extension ◽  
Group 1

Objective: To evaluate the clinicopathological characteristics of grade group 1 (GG1) prostate cancer in Korean populations.Methods: We retrospectively analyzed 492 consecutive radical prostatectomy specimens from our institution, which included those from 322 men with clinical GG1 and 170 with clinical GG2 tumors between years 2009 and 2018. The incidence of Gleason score (GS) upgrading, extraprostatic extension (EPE), and seminal vesicle invasion (SVI) were evaluated in patients with clinical GG1. In pathological GG1 cases, the distribution of adverse pathological features including EPE, lymphovascular invasion (LVI), perineural invasion (PNI), and biochemical recurrence (BCR) was analyzed.Results: Altogether, 78 (24.2%) out of 322 men in the clinical GG1 group demonstrated upgrading of GS, including 19 men with pathological Gleason score 4 + 3 = 7 and 6 with ≥ pathological Gleason score 4 + 4 = 8 cases. EPE was found in 37 (11.5%) and 22 (8.9%) men in clinical GG1 and pathological GG1 group, respectively. The incidence of LVI and PNI in the pathological GG1 cases was 2.8% (n = 7) and 28.6% (n = 71), respectively. BCR was observed in 4 men in pathological GG1 T2 (n = 226) and 2 men in GG1 T3 (n = 22) group. When we compared the pathological features between pathological GG1 T3 vs. GG2 T2, there was no statistical differences in the incidence of LVI and PNI between the two groups.Conclusions: Contrary to the current concept that GG1 is almost always clinically insignificant, it seems that GG1 still possess its respectable position as a group of cancer with aggressiveness. These findings should be kept in mind when deciding on treatment options for prostate cancer patients in the Asian populations.

scholarly journals Hypoxia-Inducible Factor 2a Expression Is Positively Correlated With Gleason Score in Prostate Cancer

2021 ◽  
Vol 20 ◽  
pp. 153303382199001
Author(s):  
Dimitrios Pavlakis ◽  
Spyridon Kampantais ◽  
Konstantinos Gkagkalidis ◽  
Victoras Gourvas ◽  
Dimitrios Memmos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Locally Advanced ◽  
Hypoxia Inducible Factor ◽  
Immunohistochemical Expression ◽  
Locally Advanced Prostate Cancer ◽  
Grade Group ◽  
Main Factors ◽  
Hif Pathway ◽  
Lower Expression

Background: One of the main factors in response to hypoxia in the tumor microenvironment is the hypoxia-inducible factor (HIF) pathway. Although its role in other solid tumors, particularly renal cell carcinoma, has been sufficiently elucidated, it remains elusive in prostate cancer. The aim of the present study was to investigate the expression of main proteins involved in this pathway and determine the correlation of the results with clinicopathological outcomes of patients with prostate cancer. Methods: The immunohistochemical expression of HIF-1a, HIF-2a and their regulators, prolyl hydroxylase domain (PHD)1, PHD2 and PHD3 and factor inhibiting HIF (FIH), was assessed on a tissue microarray. This was constructed from radical prostatectomy specimens, involving both tumor and corresponding adjacent non-tumoral prostate tissues from 50 patients with localized or locally advanced prostate cancer. Results: In comparison with non-tumoral adjacent tissue, HIF-1a exhibited an equal or lower expression in 86% of the specimens (P = 0.017), while HIF-2a was overexpressed in 52% (P = 0.032) of the cases. HIF-1a protein expression was correlated with HIF-2a (P < 0.001), FIH (P = 0.004), PHD1 (P < 0.001), PHD2 (P < 0.001) and PHD3 (P = 0.035). HIF-2a expression was positively correlated with Gleason score (P = 0.017) and International Society of Urological Pathologists (ISUP) grade group (P = 0.022). Conclusions: The findings of the present study suggest a key role for HIF-2a in prostate cancer, as HIF-2a expression was found to be correlated with Gleason score and ISUP grade of the patients. However, further studies are required to validate these results and investigate the potential value of HIF-2a as a therapeutic target in prostate cancer.

scholarly journals Predictive Factors for Positive Surgical Margins in Patients With Prostate Cancer After Radical Prostatectomy: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Lijin Zhang ◽  
Hu Zhao ◽  
Bin Wu ◽  
Zhenlei Zha ◽  
Jun Yuan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Predictive Factors ◽  
Meta Analysis ◽  
Positive Lymph Node ◽  
Pathological Stage ◽  
Positive Surgical Margins ◽  
Subgroup Analyses ◽  
Biopsy Gleason Score ◽  
Extraprostatic Extension

Background and ObjectivesPrevious studies have demonstrated that positive surgical margins (PSMs) were independent predictive factors for biochemical and oncologic outcomes in patients with prostate cancer (PCa). This study aimed to conduct a meta-analysis to identify the predictive factors for PSMs after radical prostatectomy (RP).MethodsWe selected eligible studies via the electronic databases, such as PubMed, Web of Science, and EMBASE, from inception to December 2020. The risk factors for PSMs following RP were identified. The pooled estimates of standardized mean differences (SMDs)/odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A fixed effect or random effect was used to pool the estimates. Subgroup analyses were performed to explore the reasons for heterogeneity.ResultsTwenty-seven studies including 50,014 patients with PCa were eligible for further analysis. The results showed that PSMs were significantly associated with preoperative prostate-specific antigen (PSA) (pooled SMD = 0.37; 95% CI: 0.31–0.43; P &lt; 0.001), biopsy Gleason Score (&lt;6/≥7) (pooled OR = 1.53; 95% CI:1.31–1.79; P &lt; 0.001), pathological Gleason Score (&lt;6/≥7) (pooled OR = 2.49; 95% CI: 2.19–2.83; P &lt; 0.001), pathological stage (&lt;T2/≥T3) (pooled OR = 3.90; 95% CI: 3.18–4.79; P &lt; 0.001), positive lymph node (PLN) (pooled OR = 3.12; 95% CI: 2.28–4.27; P &lt; 0.001), extraprostatic extension (EPE) (pooled OR = 4.44; 95% CI: 3.25–6.09; P &lt; 0.001), and seminal vesicle invasion (SVI) (pooled OR = 4.19; 95% CI: 2,87–6.13; P &lt; 0.001). However, we found that age (pooled SMD = 0.01; 95% CI: −0.07–0.10; P = 0.735), body mass index (BMI) (pooled SMD = 0.12; 95% CI: −0.05–0.30; P = 0.162), prostate volume (pooled SMD = −0.28; 95% CI: −0.62–0.05; P = 0.097), and nerve sparing (pooled OR = 0.90; 95% CI: 0.71–1.14; P = 0.388) had no effect on PSMs after RP. Besides, the findings in this study were found to be reliable by our sensitivity and subgroup analyses.ConclusionsPreoperative PSA, biopsy Gleason Score, pathological Gleason Score, pathological stage, positive lymph node, extraprostatic extension, and seminal vesicle invasion are independent predictors of PSMs after RP. These results may helpful for risk stratification and individualized therapy in PCa patients.

scholarly journals Androgen Receptor Expression of Prostate Cancer Correlates with Gleason Score and Perineural Invasion in West Sumatera, Indonesia

2020 ◽  
Vol 7 (11) ◽  
pp. 5125-5129
Author(s):  
Anandia Putriyuni ◽  
Meta Zulyati Oktora
Keyword(s):  
Prostate Cancer ◽  
Androgen Receptor ◽  
Gleason Score ◽  
Cancer Progression ◽  
Perineural Invasion ◽  
Receptor Expression ◽  
Grade Group ◽  
Who Grade ◽  
Who Grade Group ◽  
Histopathological Grading

Prostate cancer is the second most common and the fifth leading cause of death by cancer in men worldwide now. The failure of androgen deprivation therapy (ADT) for prostate cancer caused by activated androgen receptor (AR) signaling pathways mostly found. The role of AR in growth and progression of prostate cancer is still unclear. Analysis of AR expression in prostate cancer has never been done in West Sumatera. This study aims to determine AR expression of prostate cancer and correlate with Gleason score and perineural invasion. A total of 56 prostate cancer from department of anatomical pathology in West Sumatera. Hematoxylin and eosin (HE) stained slides and paraffin blocks were retrieved. Slides of all cases were evaluated to review Gleason score, histopathological grading, WHO grade group based on ISUP 2014/WHO 2016 and perineural invasion. Androgen receptor immunohistochemistry (IHC) was applied on all cases. High AR expression was the mostly found (51,79%). The mostly prostate cancer is Gleason score 9 (44,64%), histopathological grading poorly differentiated/undifferentiated (76,78%), WHO grade group 5 (48,21%). Perineural invasion was noted in 39,29%. There was significant statistical correlation between AR expression and Gleason score, but no significant correlation with perineural invasion. AR expression is the important marker of prostate cancer progression.

scholarly journals Patient-level detection of grade group ≥2 prostate cancer using quantitative diffusion MRI

2021 ◽  
Author(s):  
Allison Y Zhong ◽  
Leonardino A Digma ◽  
Troy Hussain ◽  
Christine H Feng ◽  
Christopher C Conlin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Characteristic Curve ◽  
Grade Group ◽  
Bootstrap Confidence Intervals ◽  
Patient Level ◽  
Apparent Diffusion ◽  
Spectrum Imaging ◽  
Group 2 ◽  
Clinically Significant ◽  
Group 1

Purpose: Multiparametric MRI (mpMRI) improves detection of clinically significant prostate cancer (csPCa), but the qualitative PI-RADS system and quantitative apparent diffusion coefficient (ADC) yield inconsistent results. An advanced Restrictrion Spectrum Imaging (RSI) model may yield a better quantitative marker for csPCa, the RSI restriction score (RSIrs). We evaluated RSIrs for patient-level detection of csPCa. Materials and Methods: Retrospective analysis of men who underwent mpMRI with RSI and prostate biopsy for suspected prostate cancer from 2017-2019. Maximum RSIrs within the prostate was assessed by area under the receiver operating characteristic curve (AUC) for discriminating csPCa (grade group ≥2) from benign or grade group 1 biopsies. Performance of RSIrs was compared to minimum ADC and PI-RADS v2-2.1via bootstrap confidence intervals and bootstrap difference (two-tailed α=0.05). We also tested whether the combination of PI-RADS and RSIrs (PI-RADS+RSIrs) was superior to PI-RADS, alone. Results: 151 patients met criteria for inclusion. AUC values for ADC, RSIrs, and PI-RADS were 0.50 [95% confidence interval: 0.41, 0.60], 0.76 [0.68, 0.84], and 0.78 [0.71, 0.85], respectively. RSIrs (p=0.0002) and PI-RADS (p<0.0001) were superior to ADC for patient-level detection of csPCa. The performance of RSIrs was comparable to that of PI-RADS (p=0.6). AUC for PI-RADS+RSIrs was 0.84 [0.77, 0.90], superior to PI-RADS or RSIrs, alone (p=0.008, p=0.009). Conclusions: RSIrs was superior to conventional ADC and comparable to (routine, clinical) PI-RADS for patient-level detection of csPCa. The combination of PI-RADS and RSIrs was superior to either alone. RSIrs is a promising quantitative marker worthy of prospective study in the setting of csPCa detection.

scholarly journals PD50-04 UTILITY OF MULTIPARAMETRIC MRI IN THE RISK STRATIFICATION OF MEN WITH GRADE GROUP 1 PROSTATE CANCER ON ACTIVE SURVEILLANCE

2019 ◽  
Vol 201 (Supplement 4) ◽  
Author(s):  
Mufaddal Mamawala* ◽  
Alexa Meyer ◽  
Patricia Landis ◽  
Katarzyna Macura ◽  
Jonathan Epstein ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Stratification ◽  
Active Surveillance ◽  
Multiparametric Mri ◽  
Grade Group ◽  
Group 1
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