Quantification of Gleason Pattern 4 Metrics Identifies Pathologic Progression in Patients With Grade Group 2 Prostate Cancer on Active Surveillance.

Autor: Perera M; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Assel M; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY., Nalavenkata S; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Khaleel S; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Benfante N; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Carlsson SV; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY., Reuter VE; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY., Laudone VP; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Scardino PT; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Touijer KA; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Eastham JA; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY., Vickers AJ; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY., Fine SW; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY., Ehdaie B; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: ehdaieb@mskcc.org.
Jazyk: angličtina
Zdroj: Clinical genitourinary cancer [Clin Genitourin Cancer] 2024 Aug 14; Vol. 22 (6), pp. 102204. Date of Electronic Publication: 2024 Aug 14.
DOI: 10.1016/j.clgc.2024.102204
Abstrakt: Background: During active surveillance (AS) for Grade Group (GG) 2 prostate cancer, pathologic progression to GG3 on surveillance biopsy is a trigger for intervention. However, this ratio of GP3:GP4, may be obscured by increases of relatively indolent disease. We aimed to explore changes in GP4 quantity during AS and propose alternative definitions for progression based on GP4 changes.
Design, Setting, and Participants: We assessed patients enrolled on AS between November 2014 and March 2020 with GG2 disease on diagnostic biopsy and subsequent surveillance biopsy approximately 1 year later. Outcome measures included change in overall %GP4 and total length GP4 (mm).
Results and Limitations: 61 patients met the inclusion criteria, the median change in total length of GP4 and %GP4 was -0.12 mm (IQR -0.31, 0.09) and -2.5% (IQR -8.6, 0.0), respectively. Excluding the 35 patients with no evidence of GP4 on surveillance biopsy, median change in total GP4 length and %GP4 was 0.19 mm (IQR -0.04, 0.67) and 1.2% (IQR -1.6, 6.6), respectively. Three patients progressed to GG3 disease on surveillance biopsy, one of whom had only a small increase in %GP4. Conversely, an additional 2 patients who did not meet the criterion for GG3 had a large increase (> 1 mm) in total GP4 length.
Conclusions: Presence of GG3 disease on surveillance biopsy as a trigger for treatment in men on AS is of questionable use alone; we suggest including other measures that do not depend on a ratio, such as an increase in total GP4 length.
Competing Interests: Disclouser All conflicts of interest, including specific financial interests, relations and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment, affiliations, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties filed, received or pending, personal relationships), are listed below: Peter T. Scardino is named on a patent for a statistical method to detect prostate cancer that has been commercialized by OPKO Health (from which he receives royalties and stock options) and chairs the Medical Advisory board of Insightec as an unpaid consultant. Andrew J. Vickers is named on a patent for a statistical method to detect prostate cancer that has been commercialized by OPKO Health (from which he receives royalties and stock options) and has received consulting funds from Insightec and Steba. None of these companies contributed to or directed any of the research reported in this article. The other authors declare no conflict of interest, including specific financial interests or relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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