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Title: Validation of the novel 5-group Gleason grading system: 3+5 disease risk may be overestimated.
Authors: Van den Bergh, Roderick
Zargar, Homayoun
Murphy, Declan
Keywords: Urology
Biochemical Recurrence
Prostate Cancer
Poster 50
Prognostic Stratification
Gleason Score
Prognostic Grade Groups
UroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australia
Australian Prostate Cancer Research Epworth Healthcare, Victoria, Australia.
Issue Date: Jul-2016
Citation: Research Week 2016, Poster 50, pp76.
Conference Name: Epworth Research Institute; Research Week 2016
Conference Location: Epworth HealthCare, Richmond, Victoria, 3121 Australia.
Abstract: Introduction/ background: The international Society of Urological Pathology, suggested to change the classical Gleason grading system to 5 prognostic grade groups (1: 3+3, 2: 3+4, 3: 4+3, 4: Gleason score 8, and 5: Gleason score 9-10). We compared the predictive value for biochemical recurrence (BCR) after surgery of the classical grading system to the new risk group system. Method: The radical prostatectomy database from a single centre was used. BCR was defined as a post-operative PSA of >=0.2 ng / ml and rising. the classical 9-group system was compared to the novel 5-group system. Kaplan-Meier curves with Log-Rank test for comparisons between curves were used. P-values of <0.05 were considered statistically significant. Results: For biopsy, the classical grading showed overlap between different subgroups of Gleason 7 and 8 between 8 and 9 ( all p>0.05). The new risk group 2 overlapped with 3 (p=0.282), and 3 with 4 (p=0.161), other group comparisons were significantly different. For prostatectomy, the classical grading showed overlap between different Gleason 9 subgroups and 10 ( all p>0.05). The new risk group 3 overlapped with 4 (p=0.893), other group comparisons were significantly different. Within risk group 4, 3+5 patients (3-year BCR-free 65%) had more favourable (p<0.01) BCR than 4+4 patients (18%) and were even similar (p=0.524) to 3+4 (73% [Figure]. No corrections for margin or lymph node status were made. Conclusion: Condensing the classical 9-group Gleason system to the suggested 5-group system resulted in less overlap between BCR rates, suggesting increased prognostic stratification value between some higher risk disease patients may be lost. Most markedly, the risk of prostatectomy Gleason 3+5 patients (new risk group 4) may be overestimated, as the BCR resembles that of Gleason 3+4 (new risk group) patients.
Type: Conference Poster
Affiliated Organisations: Peter MacCallum Cancer Centre, Victoria, Australia.
Royal Melbourne Hospital, Victoria, Australia.
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Research Week
UroRenal, Vascular

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