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Population‐Based Validation of the 2014 ISUP Gleason Grade Groups in Patients Treated With Radical Prostatectomy, Brachytherapy, External Beam Radiation, or no Local Treatment
Author(s) -
Pompe Raisa S.,
DavisBondarenko Helen,
Zaffuto Emanuele,
Tian Zhe,
Shariat Shahrokh F.,
LeyhBannurah SamiRamzi,
Schiffmann Jonas,
Saad Fred,
Huland Hartwig,
Graefen Markus,
Tilki Derya,
Karakiewicz Pierre I.
Publication year - 2017
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.23316
Subject(s) - medicine , prostatectomy , prostate cancer , brachytherapy , nomogram , prostate , nuclear medicine , population , radiation therapy , urology , external beam radiotherapy , proportional hazards model , surgery , oncology , cancer , environmental health
BACKGROUND To test discriminant ability of the 2014 ISUP Gleason grade groups (GGG) for prediction of prostate cancer specific mortality (PCSM) after radical prostatectomy (RP), brachytherapy (BT), external beam radiation (EBRT) or no local treatment (NLT) relative to traditional Gleason grading (TGG). METHODS In the Surveillance, Epidemiology, and End Results (SEER)‐database (2004–2009), 2,42,531 non‐metastatic prostate cancer (PCa) patients were identified, who underwent local treatment (RP, BT, EBRT only) or NLT. Follow‐up endpoint was PCSM. Biopsy and/or pathological Gleason score (GS) were categorized as TGG ≤6, 7, 8–10 or GGG: I (≤6), II (3 + 4), III (4 + 3), IV (8), and V (9–10). Kaplan–Meier plots, multivariable Cox regression analyses and receiver operating characteristics (ROC) area under the curve analyses (AUC) were used. RESULTS Median follow‐up was 76 months (IQR: 59–94). For the four examined treatment modalities, all five GGG strata and all three TGG strata independently predicted PCSM. GGG yielded 1.5‐fold or greater HR differences between GGG II and GGG III, and twofold or greater HR differences between GGG IV and GGG V. Relative to TGG, GGG added 0.4–1.1% to AUC. CONCLUSIONS This large population‐based cohort study confirms the added discriminant properties of the novel GGG strata and confirms a modest gain in predictive accuracy. Prostate 77: 686–693, 2017 . © 2017 Wiley Periodicals, Inc.