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Grade Group 1 Prostate Cancer Outcome by Biopsy Grade and Risk Group.

Neal A Patel1, Daniel A Barocas2, Daniel W Lin3

  • 1Department of Urology, Weill Cornell Medicine, New York, New York.

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This summary is machine-generated.

Not all Grade Group 1 (GG1) prostate cancers are indolent. This study found that about 1 in 6 men with GG1 prostate cancer have intermediate or high-risk disease, with outcomes similar to higher-grade cancers.

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Area of Science:

  • Urology
  • Oncology
  • Cancer Research

Background:

  • Prostate cancer Grade Group 1 (GG1) is often considered indolent.
  • Arguments exist to remove the cancer label from GG1 prostate cancer based on low metastasis rates when detected only at prostatectomy.
  • However, the long-term outcomes and adverse clinical features associated with GG1 prostate cancer detected on biopsy are not well-defined.

Purpose of the Study:

  • To evaluate cancer-specific outcomes for localized GG1 prostate cancer.
  • To stratify outcomes based on National Comprehensive Cancer Network (NCCN) risk categories.

Main Methods:

  • A population-based cohort study utilizing Surveillance, Epidemiology, and End Results (SEER) data.
  • Analysis of 117,162 men with localized GG1 prostate cancer from January 1, 2010, to December 31, 2020.
  • Competing risk analyses and multivariable regression to determine prostate cancer-specific mortality and adverse pathology rates.

Main Results:

  • Among 117,162 men with biopsy GG1 prostate cancer, 9% had favorable intermediate-risk, 3% unfavorable intermediate-risk, and 4% high-risk disease.
  • 60% of high-risk GG1 cases showed adverse pathology at prostatectomy.
  • Prostate cancer-specific mortality rates for unfavorable intermediate-risk GG1 (2.4%) and high-risk GG1 (4.7%) were comparable to higher-grade cancers (GG2).

Conclusions:

  • Biopsy GG1 prostate cancer exhibits heterogeneous long-term outcomes, including adverse pathology and mortality.
  • A significant subset of GG1 prostate cancer cases present with intermediate or high-risk disease.
  • These findings challenge the notion that all GG1 prostate cancer is indolent and should inform the ongoing reclassification debate.