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Validation of the Five-Tiered Gleason Grade Grouping System in Patients With Prostate Cancer

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Key Points

  • The risk of prostate cancer–specific mortality nearly doubled with each Gleason grade grouping increase.
  • Among men who underwent radical prostatectomy and using GGG1 (Gleason score ≤6) as the reference group, the adjusted hazard ratio for prostate cancer–specific mortality was 1.13 for GGG2, 1.87 for GGG3, 5.03 for GGG4, and 10.92 for GGG5.
  • Similar patterns were observed regardless of the type of primary cancer treatment received or clinical stage.

Scientists have been able to validate the recently proposed five-tiered system of Gleason grade grouping using population-based data. The study, led by Grace Lu-Yao, PhD, MPH, Associate Director for Population Science at the Sidney Kimmel Cancer Center at Thomas Jefferson University and Vice Chair and Professor in the Department of Medical Oncology at the Sidney Kimmel Medical College with a joint appointment at the Jefferson College of Population Health, was published by He et al in the Journal of European Urology.

The research confirms that the five-tiered Gleason grade grouping (GGG) system is effectively able to predict mortality rate among patients with prostate cancer.

Using the Surveillance, Epidemiology, and End Results (SEER) database, researchers evaluated 331,320 patients with prostate cancer who were diagnosed between January 2006 and December 2012 and had primary and secondary Gleason patterns. Researchers then quantified the risk of prostate cancer–specific mortality and discovered that the risk of prostate cancer–specific mortality nearly doubled with each GGG increase.

Among men who underwent radical prostatectomy and using GGG1 (Gleason score ≤6) as the reference group, the adjusted hazard ratio for prostate cancer–specific mortality was 1.13 (95% confidence interval [CI] = 0.83–1.54) for GGG2, 1.87 (95% CI = 1.33–2.65) for GGG3, 5.03 (95% CI = 3.59–7.06) for GGG4, and 10.92 (95% CI = 8.03–14.84) for GGG5. Similar patterns were observed regardless of the type of primary cancer treatment received or clinical stage.

The study concludes that the new five-tiered Gleason grade grouping system predicts prostate cancer–specific mortality well, regardless of the cancer treatment received or clinical stage at diagnosis, and can serve as a useful tool in determining treatment decisions.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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