Gearman DJ, et al. - Researchers pursued a clarification of the risk of adverse features and oncologic outcomes for surgically-treated favorable GG2 vs GG1 patients, in the case of prostate cancer. Based on the results, it was deduced that favorable-risk GG2 men considering active surveillance (AS) ought to be informed of the risks of harboring adverse pathologic features, that influenced the secondary therapies and an increased risk of cancer progression.

Methods

• An analysis was conducted of the RP database in search of all patients with biopsy GG1 or GG2 PCa who otherwise fulfilled the NCCN “low risk” definition (PSA < 10 ng/ml, cT≤2a) and underwent radical prostatectomy (RP) from 1987 to 2014 (n = 8095).
• In order to to compare pathologic and oncologic outcomes, researchers undertook multivariable logistic regression and Kaplan-Meier methods.

Results

• The occurrence of organ-confined disease was noted in 93.9% and 82.6% of GG1 and FIR GG2 patients, seminal vesicle invasion in 1.7% vs 4.7%, and nodal disease in 0.3% vs 1.8%, respectively (all p < 0.0001).
• The multivariable logistic regression demonstrated that having biopsy proven GG2 disease correlated with a 3-fold greater risk of non-organ confined disease (OR 3.1, 95% CI 1.7-5.7, p < 0.001).
• As per the findings, it was determined that the use of late treatments (>90d from surgery) for GG1 vs GG2 was 3.1% vs 8.5% (hormonal) and 6.0% vs 12.2% (radiation), respectively (p < 0.001).
• 10 year BCR free survival was demonstrated to be 88.9% vs. 81.2% (p < 0.001) and 10 year systemic progression free survival 99% vs. 96.5% (p < 0.001) for GG1 vs. GG2 cohorts, respectively.