Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Barletta, F; Tappero, S; Morra, S; Incesu, RB; Garcia, CC; Piccinelli, ML; Scheipner, L; Tian, Z; Gandaglia, G; Stabile, A; Mazzone, E; Terrone, C; Longo, N; Tilki, D; Chun, FKH; de, Cobelli, O; Ahyai, S; Saad, F; Shariat, SF; Montorsi, F; Briganti, A; Karakiewicz, PI.
Impact of ISUP grade group on cancer-specific mortality in radical prostatectomy-treated prostate cancer patients with organ-confined disease.
Can Urol Assoc J. 2025;
Doi: 10.5489/cuaj.8941
[OPEN ACCESS]
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Ahyai Sascha
- Scheipner Lukas
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- INTRODUCTION: We aimed to test the impact of International Society of Urological Pathology (ISUP) grade group (GG) on cancer-specific mortality (CSM) in organ-confined (pT2) prostate cancer (PCa) at radical prostatectomy (RP). METHODS: RP organ-confined prostate cancer (PCa) patients were identified (Surveillance, Epidemiology, and End Results 2004-2015). Cancer-specific survival (CSS) rates were tested in Kaplan-Meier plots and multivariable Cox regression (MCR) models according to GG: 1-3 vs. 4 vs. 5. Sensitivity analyses addressed GG4 and GG5 patients with available primary and secondary Gleason score (GS). RESULTS: Overall, 61 172 patients with RP organ-confined PCa were identified. Of these, 57 715 (94.4%), 2036 (3.3%) and 1421 (2.3%) harbored GG1-3, 4, and 5, respectively. In Kaplan-Meier analyses, seven-years' CSS estimates were 99.6 vs. 98.2 vs. 93.8% for GG1-3 vs. 4 vs. 5, respectively (p<0.001). In MCR models, GG4 (hazard ratio [HR] 2.72, p<0.001) and 5 (HR 9.95, p<0.001) independently predicted higher CSM, relative to GG1-3. Furthermore, GG5 also independently predicted higher CSM (HR 3.72, p<0.001) vs. GG4. In sensitivity analyses, 1.2, 1.6, and 2.4 CSM events per 1000 person-years of followup were respectively recorded for GS 4+4, 3+5, and 5+3 patients. Conversely, 4.8 vs. 5.3 CSM events per 1000 person-years of followup were respectively recorded for GS 4+5 vs. 5+4/5+5 patients. CONCLUSIONS: In organ-confined PCa, at RP, a small proportion of patients harbor GG4-5. These patients exhibit higher CSM than their GG1-3 counterparts. Moreover, detectable mortality rate differences indicate a dose-response effect according to primary and secondary GS. This phenomenon applies in both GG4 and GG5, as well as between GG4 and GG5.