Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings

BMC Cancer

Research Article

D. M. Roder¹  K. R. Beckmann²  K. L. Moretti³  S. M. Evans⁴  S. Chang⁵  P. Cohen⁵  A. D. Vincent⁶  M. Borg⁷  M. E. O’Callaghan⁸ 

[1] Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia;Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia;South Australian Prostate Cancer Clinical Outcomes Collaborative, Repatriation General Hospital, Adelaide, Australia;Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia;South Australian Prostate Cancer Clinical Outcomes Collaborative, Repatriation General Hospital, Adelaide, Australia;School of Medicine, University of Adelaide, Adelaide, Australia;Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia;Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia;SA Pathology, Health SA, Adelaide, Australia;School of Medicine, University of Adelaide, Adelaide, Australia;South Australian Prostate Cancer Clinical Outcomes Collaborative, Repatriation General Hospital, Adelaide, Australia;School of Medicine, University of Adelaide, Adelaide, Australia;Adelaide Radiotherapy Centre, Adelaide, Australia;South Australian Prostate Cancer Clinical Outcomes Collaborative, Repatriation General Hospital, Adelaide, Australia;School of Medicine, University of Adelaide, Adelaide, Australia;Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia;

关键词: Prostate cancer;    Grade groups;    Clinical outcomes;    Survival;    Biochemical recurrence;   

DOI  :  10.1186/s12885-017-3533-9

 received in 2016-12-20, accepted in 2017-08-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundA 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.MethodsParticipants 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.ResultsFor 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.ConclusionIn 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.

【 授权许可】

CC BY   
© The Author(s). 2017