MP45-07 ONCOLOGIC OUTCOMES OF TOTAL LENGTH GLEASON PATTERN 4 ON BIOPSY IN MEN WITH GRADE GROUP 2 PROSTATE CANCER (2022)

You have accessJournal of UrologyCME1 May 2022MP45-07 ONCOLOGIC OUTCOMES OF TOTAL LENGTH GLEASON PATTERN 4 ON BIOPSY IN MEN WITH GRADE GROUP 2 PROSTATE CANCER Marlon Perera, Melissa Assel, Nicole Benfante, Andrew Vickers, Victor Reuter, Sigrid Carlsson, Vincent Laudone, Karim Touijer, James Eastham, Peter Scardino, Samson Fine, and Behfar Ehdaie Marlon PereraMarlon Perera More articles by this author , Melissa AsselMelissa Assel More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Andrew VickersAndrew Vickers More articles by this author , Victor ReuterVictor Reuter More articles by this author , Sigrid CarlssonSigrid Carlsson More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , Karim TouijerKarim Touijer More articles by this author , James EasthamJames Eastham More articles by this author , Peter ScardinoPeter Scardino More articles by this author , Samson FineSamson Fine More articles by this author , and Behfar EhdaieBehfar Ehdaie More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002611.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Gleason Score 7 prostate cancer (including Grade Group (GG) 2 and GG3) represents a widely heterogenous disease process, and precise sub-stratification of this cohort is paramount. Our group previously demonstrated that the total length of Gleason pattern 4 (GP4) across all biopsy cores has been shown to be associated with adverse pathologic outcomes after radical prostatectomy. We aimed to determine the association of GP4 length on prostate biopsy on post-prostatectomy oncologic outcomes. METHODS: We compared four GP4 quantification methods including: maximum %GP4 in any single core, overall %GP4 (mm of GP4/total mm of cancer), total length GP4 (mm) across all cores, and length GP4 (mm) in the core with the greatest volume of GP4. for prediction of biochemical recurrence–free survival after radical prostatectomy using multivariable Cox proportional hazards regression. RESULTS: A total of 457 men with Grade Group 2 prostate cancer on biopsy subsequently underwent radical prostatectomy at our institution. The 3-year biochemical recurrence–free survival probability was 85% (95% CI 81–88%). On multivariable analysis, all four GP4 quantification methods—maximum %GP4 (HR=1.30; 95% CI 1.07–1.59; p=0.009), overall %GP4 (HR=1.61; 95% CI 1.21–2.15; p=0.001), total length GP4 (HR=2.48; 95% CI 1.36–4.52; p=0.003), and total length GP4 in highest core (HR=1.32; 95% CI 1.11–1.57; p=0.001)—were significantly associated with BCR. Models including all methods of GP4 quantification resulted in a meaningful increase in discrimination of BCR risk, with similar gains in Harrell’s C-index ranging from 0.017 to 0.019. CONCLUSIONS: These findings further support routine reporting of and inclusion of GP4 quantification in pathology reports and risk prediction models for patients with Grade Group 2 prostate cancer. These data also support studying GP4 quantification as a surrogate endpoint for disease progression for trials, including those of men managed with active surveillance. Source of Funding: This work was supported by the Sidney Kimmel Center for Prostate and Urologic Cancers at MSK, the NIH/NCI grant P50 CA092629, and the NIH/NCI Cancer Center Support Grant to Memorial Sloan Kettering Cancer Center (P30 CA008748). Marlon Perera is sponsored by the Australian-America Fulbright Commission administered through a 2021-2022 Fulbright Future Scholarship funded by The Kinghorn Foundation. Sigrid Carlsson is supported by a NIH/NCI grant K22-CA234400 © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e764 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marlon Perera More articles by this author Melissa Assel More articles by this author Nicole Benfante More articles by this author Andrew Vickers More articles by this author Victor Reuter More articles by this author Sigrid Carlsson More articles by this author Vincent Laudone More articles by this author Karim Touijer More articles by this author James Eastham More articles by this author Peter Scardino More articles by this author Samson Fine More articles by this author Behfar Ehdaie More articles by this author Expand All Advertisement PDF DownloadLoading ...