The authors reviewed their dataset of 1127 consecutive radical prostatectomies performed between 2012−2015 at various community and academic medical centers in the region (Chicago). Of these, 314 patients were found to have ISUP Gleason Grade 1 disease on final pathology (without centralized pathology review).
Importantly, in this cohort, only 4.1% had pT3 disease (12 patients stage pT3a and 1 stage pT3b). As such, men with with pT3 Gleason 3+3=6 PCa represent a small fraction of all radical prostatectomies completed in the modern era.
However, it should be noted that this study was done in the era of active surveillance. So many Gleason 3+3=6 PCa patients are likely not receiving treatment – hence, these patients were selected for treatment either for symptoms or more aggressive pathology on biopsy. This is actually reassuring, as even in these higher risk patients, there is a very low rate of pT3 disease.
Unfortunately, the authors do not elaborate further on other pathologic findings such as margin positivity, node positivity, etc. Nor do they report long-term clinical outcomes. This limits the utility of their results. But, as it encompasses both academic and community practice, it is reassuring that community practice mirrors academic practice.
Speaker: David Greenwald
Co-authors: Alice Y. Wang, Jason Huang, Harpreet Wadhwa, Tony Nimeh, Justin J. Cohen, Paul Yonover
Institution(s): University of Illinois at Chicago, Chicago, IL; Vanderbilt University, Nashville, TN; Uropartners, Chicago, IL
Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, Twitter: @tchandra_uromd at the 2018 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, February 8-10, 2018 - San Francisco, CA