Quantification of Gleason Pattern 4 Metrics Identifies Pathologic Progression in Patients With Grade Group 2 Prostate Cancer on Active Surveillance
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View abstract on PubMed
Summary
This summary is machine-generated.Active surveillance for Grade Group 2 prostate cancer may need new progression criteria. Focusing solely on Grade Group 3 (GG3) may miss increases in Grade Group 4 (GP4) quantity, suggesting GP4 length is a better measure.
Area Of Science
- Urology
- Oncology
- Pathology
Background
- Active surveillance (AS) is used for Grade Group (GG) 2 prostate cancer.
- Progression to GG3 on biopsy triggers intervention.
- Current criteria may be obscured by indolent disease changes.
Purpose Of The Study
- To explore changes in Grade Group 4 (GP4) quantity during AS.
- To propose alternative progression definitions based on GP4 changes.
Main Methods
- Assessed patients on AS with GG2 disease on diagnostic biopsy.
- Evaluated subsequent surveillance biopsy approximately 1 year later.
- Measured changes in overall %GP4 and total length GP4 (mm).
Main Results
- Median change in GP4 length was -0.12 mm and %GP4 was -2.5% in 61 patients.
- Excluding patients with no GP4, median change was 0.19 mm and 1.2% increase.
- Three patients progressed to GG3; 2 others had significant GP4 length increases without meeting GG3 criteria.
Conclusions
- GG3 presence alone is a questionable trigger for treatment in AS.
- Suggests incorporating GP4 length increase as a progression measure.
- Alternative definitions for progression may improve AS management.
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