Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings
Abstract Background A new 5-tiered grading grouping system has recently been endorsed for reporting of prostate cancer (PCa) grade to better reflect escalating risk of progression and cancer death. While several validations of the new grade groupings have been undertaken, most have involved centrali...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-08-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12885-017-3533-9 |
| _version_ | 1819115217795153920 |
|---|---|
| author | K. R. Beckmann A. D. Vincent M. E. O’Callaghan P. Cohen S. Chang M. Borg S. M. Evans D. M. Roder K. L. Moretti for the South Australia Prostate Cancer Clinical Outcomes Collaborative |
| author_facet | K. R. Beckmann A. D. Vincent M. E. O’Callaghan P. Cohen S. Chang M. Borg S. M. Evans D. M. Roder K. L. Moretti for the South Australia Prostate Cancer Clinical Outcomes Collaborative |
| author_sort | K. R. Beckmann |
| collection | DOAJ |
| description | Abstract Background A new 5-tiered grading grouping system has recently been endorsed for reporting of prostate cancer (PCa) grade to better reflect escalating risk of progression and cancer death. While several validations of the new grade groupings have been undertaken, most have involved centralised pathological review by specialist urological pathologists. Methods Participants included 4268 men with non-metastatic PCa diagnosed between 2006 and 2013 from the multi-institutional South Australia Prostate Cancer Clinical Outcomes Collaborative registry. PCa-specific survival and biochemical recurrence-free survival were compared across the five grade groups using multivariable competing risk regression. Results For the entire cohort, risk of PCa death increased with increasing grade groups (at biopsy) Adjusted subdistribution-hazard ratios [sHR] and 95% confidence intervals [95%CI] were: 2.2 (1.5–3.6); 2.5 (1.6–4.2); 4.1 (2.6–6.7) and 8.7 (4.5–14.0) for grade groups II (pattern 3 + 4), III (pattern 4 + 3), IV (total score 8) and V (total score 9–10) respectively, relative to grade group I (total score < =6). Clear gradients in risk of PCa death were observed for radical prostatectomy (RP), but were less clear for those who had radiotherapy (RT) with curative intent and those who were managed conservatively. Likewise, risk of biochemical recurrence increased across grade groups, with a strong and clear gradient for men undergoing RP [sHR (95%CI): 2.0 (1.4–2.8); 3.8 (2.9–5.9); 5.3 (3.5–8.0); 11.2 (6.5–19.2) for grade groups II, III, IV and V respectively, relative to grade group I], and a less clear gradient for men undergoing RT. Conclusion In general, the new five-tiered grade groupings distinguished PCa survival and recurrence outcomes for men with PCa. The absence of a clear gradient for RT may be due to heterogeneity in this patient group. |
| first_indexed | 2024-12-22T04:57:41Z |
| format | Article |
| id | doaj.art-b909539aa4d6499f88575a04ae93210e |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-22T04:57:41Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-b909539aa4d6499f88575a04ae93210e2022-12-21T18:38:21ZengBMCBMC Cancer1471-24072017-08-0117111010.1186/s12885-017-3533-9Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupingsK. R. Beckmann0A. D. Vincent1M. E. O’Callaghan2P. Cohen3S. Chang4M. Borg5S. M. Evans6D. M. Roder7K. L. Moretti8for the South Australia Prostate Cancer Clinical Outcomes CollaborativeCentre for Population Health Research, Sansom Institute for Health Research, University of South AustraliaSchool of Medicine, University of AdelaideSouth Australian Prostate Cancer Clinical Outcomes Collaborative, Repatriation General HospitalSA Pathology, Health SASA Pathology, Health SASouth Australian Prostate Cancer Clinical Outcomes Collaborative, Repatriation General HospitalDepartment of Epidemiology and Preventive Medicine, Monash UniversityCentre for Population Health Research, Sansom Institute for Health Research, University of South AustraliaCentre for Population Health Research, Sansom Institute for Health Research, University of South AustraliaAbstract Background A new 5-tiered grading grouping system has recently been endorsed for reporting of prostate cancer (PCa) grade to better reflect escalating risk of progression and cancer death. While several validations of the new grade groupings have been undertaken, most have involved centralised pathological review by specialist urological pathologists. Methods Participants included 4268 men with non-metastatic PCa diagnosed between 2006 and 2013 from the multi-institutional South Australia Prostate Cancer Clinical Outcomes Collaborative registry. PCa-specific survival and biochemical recurrence-free survival were compared across the five grade groups using multivariable competing risk regression. Results For the entire cohort, risk of PCa death increased with increasing grade groups (at biopsy) Adjusted subdistribution-hazard ratios [sHR] and 95% confidence intervals [95%CI] were: 2.2 (1.5–3.6); 2.5 (1.6–4.2); 4.1 (2.6–6.7) and 8.7 (4.5–14.0) for grade groups II (pattern 3 + 4), III (pattern 4 + 3), IV (total score 8) and V (total score 9–10) respectively, relative to grade group I (total score < =6). Clear gradients in risk of PCa death were observed for radical prostatectomy (RP), but were less clear for those who had radiotherapy (RT) with curative intent and those who were managed conservatively. Likewise, risk of biochemical recurrence increased across grade groups, with a strong and clear gradient for men undergoing RP [sHR (95%CI): 2.0 (1.4–2.8); 3.8 (2.9–5.9); 5.3 (3.5–8.0); 11.2 (6.5–19.2) for grade groups II, III, IV and V respectively, relative to grade group I], and a less clear gradient for men undergoing RT. Conclusion In general, the new five-tiered grade groupings distinguished PCa survival and recurrence outcomes for men with PCa. The absence of a clear gradient for RT may be due to heterogeneity in this patient group.http://link.springer.com/article/10.1186/s12885-017-3533-9Prostate cancerGrade groupsClinical outcomesSurvivalBiochemical recurrence |
| spellingShingle | K. R. Beckmann A. D. Vincent M. E. O’Callaghan P. Cohen S. Chang M. Borg S. M. Evans D. M. Roder K. L. Moretti for the South Australia Prostate Cancer Clinical Outcomes Collaborative Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings BMC Cancer Prostate cancer Grade groups Clinical outcomes Survival Biochemical recurrence |
| title | Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings |
| title_full | Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings |
| title_fullStr | Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings |
| title_full_unstemmed | Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings |
| title_short | Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings |
| title_sort | oncological outcomes in an australian cohort according to the new prostate cancer grading groupings |
| topic | Prostate cancer Grade groups Clinical outcomes Survival Biochemical recurrence |
| url | http://link.springer.com/article/10.1186/s12885-017-3533-9 |
| work_keys_str_mv | AT krbeckmann oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT advincent oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT meocallaghan oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT pcohen oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT schang oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT mborg oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT smevans oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT dmroder oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT klmoretti oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings AT forthesouthaustraliaprostatecancerclinicaloutcomescollaborative oncologicaloutcomesinanaustraliancohortaccordingtothenewprostatecancergradinggroupings |