Prognostic implications of 2005 Gleason grade modification: Population-based study of biochemical recurrence following radical prostatectomy

TY - JOUR

T1 - Prognostic implications of 2005 Gleason grade modification

T2 - Population-based study of biochemical recurrence following radical prostatectomy

AU - Thomsen, Frederik Birkebæk

AU - Folkvaljon, Yasin

AU - Brasso, Klaus

AU - Loeb, Stacy

AU - Robinson, David

AU - Egevad, Lars

AU - Stattin, Pär

N1 - © 2016 Wiley Periodicals, Inc.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objective: To assess the impact of the 2005 modification of the Gleason classification on risk of biochemical recurrence (BCR) after radical prostatectomy (RP). Patients and Methods: In the Prostate Cancer data Base Sweden (PCBaSe), 2,574 men assessed with the original Gleason classification and 1,890 men assessed with the modified Gleason classification, diagnosed between 2003 and 2007, underwent primary RP. Histopathology was reported according to the Gleason Grading Groups (GGG): GGG1 = Gleason score (GS) 6, GGG2 = GS 7(3 + 4), GGG3 = GS 7(4 + 3), GGG4 = GS 8 and GGG5 = GS 9–10. Cumulative incidence and multivariable Cox proportional hazards regression models were used to assess difference in BCR. Results: The cumulative incidence of BCR was lower using the modified compared to the original classification: GGG2 (16% vs. 23%), GGG3 (21% vs. 35%) and GGG4 (18% vs. 34%), respectively. Risk of BCR was lower for modified versus original classification, GGG2 Hazard ratio (HR) 0.66, (95%CI 0.49–0.88), GGG3 HR 0.57 (95%CI 0.38–0.88) and GGG4 HR 0.53 (95%CI 0.29–0.94). Conclusion: Due to grade migration following the 2005 Gleason modification, outcome after RP are more favourable. Consequently, outcomes from historical studies cannot directly be applied to a contemporary setting. J. Surg. Oncol. 2016;114:664–670.

AB - Objective: To assess the impact of the 2005 modification of the Gleason classification on risk of biochemical recurrence (BCR) after radical prostatectomy (RP). Patients and Methods: In the Prostate Cancer data Base Sweden (PCBaSe), 2,574 men assessed with the original Gleason classification and 1,890 men assessed with the modified Gleason classification, diagnosed between 2003 and 2007, underwent primary RP. Histopathology was reported according to the Gleason Grading Groups (GGG): GGG1 = Gleason score (GS) 6, GGG2 = GS 7(3 + 4), GGG3 = GS 7(4 + 3), GGG4 = GS 8 and GGG5 = GS 9–10. Cumulative incidence and multivariable Cox proportional hazards regression models were used to assess difference in BCR. Results: The cumulative incidence of BCR was lower using the modified compared to the original classification: GGG2 (16% vs. 23%), GGG3 (21% vs. 35%) and GGG4 (18% vs. 34%), respectively. Risk of BCR was lower for modified versus original classification, GGG2 Hazard ratio (HR) 0.66, (95%CI 0.49–0.88), GGG3 HR 0.57 (95%CI 0.38–0.88) and GGG4 HR 0.53 (95%CI 0.29–0.94). Conclusion: Due to grade migration following the 2005 Gleason modification, outcome after RP are more favourable. Consequently, outcomes from historical studies cannot directly be applied to a contemporary setting. J. Surg. Oncol. 2016;114:664–670.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Databases, Factual

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Neoplasm Grading

KW - Neoplasm Recurrence, Local

KW - Prognosis

KW - Proportional Hazards Models

KW - Prostate-Specific Antigen

KW - Prostatectomy

KW - Prostatic Neoplasms

KW - Journal Article

U2 - 10.1002/jso.24408

DO - 10.1002/jso.24408

M3 - Journal article

C2 - 27511833

SN - 0022-4790

VL - 114

SP - 664

EP - 670

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

IS - 6

ER -