Pompe Raisa S, Davis-Bondarenko Helen, Zaffuto Emanuele, Tian Zhe, Shariat Shahrokh F, Leyh-Bannurah Sami-Ramzi, Schiffmann Jonas, Saad Fred, Huland Hartwig, Graefen Markus, Tilki Derya, Karakiewicz Pierre I
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.
Martini-Clinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Prostate. 2017 May;77(6):686-693. doi: 10.1002/pros.23316. Epub 2017 Feb 3.
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).
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.
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.
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.
为了测试2014年国际泌尿病理学会（ISUP） Gleason分级组（GGG）相对于传统Gleason分级（TGG）在预测前列腺癌根治术（RP）、近距离放射治疗（BT）、外照射放疗（EBRT）或未进行局部治疗（NLT）后前列腺癌特异性死亡率（PCSM）方面的鉴别能力。
在监测、流行病学和最终结果（SEER）数据库（2004 - 2009年）中，识别出242531例非转移性前列腺癌（PCa）患者，这些患者接受了局部治疗（仅RP、BT、EBRT）或NLT。随访终点为PCSM。活检和/或病理Gleason评分（GS）被分类为TGG≤6、7、8 - 10或GGG：I（≤6）、II（3 + 4）、III（4 + 3）、IV（8）和V（9 - 10）。使用Kaplan - Meier曲线、多变量Cox回归分析和受试者工作特征（ROC）曲线下面积分析（AUC）。
中位随访时间为76个月（四分位间距：59 - 94个月）。对于四种检查的治疗方式，所有五个GGG分层和所有三个TGG分层均独立预测PCSM。GGG在GGG II和GGG III之间产生了1.5倍或更大的风险比（HR）差异，在GGG IV和GGG V之间产生了两倍或更大的HR差异。相对于TGG，GGG使AUC增加了0.4 - 1.1%。
这项基于大人群的队列研究证实了新型GGG分层增加的鉴别特性，并证实了预测准确性有适度提高。《前列腺》77：686 - 693，2017年。©2017威利期刊公司。
