CUA 2018: Validation of the 2015 Prostate Cancer Gleason Grade Groups for Predicting Cancer Control Outcomes after Radical Prostatectomy

Halifax, Nova Scotia ( In this retrospective analysis, the authors examined the utility of the Gleason grade groups (GGG) (1-5), correlation to Gleason scores of 6, 7(3+4), 7(4+3), 8, and >8, respectively. This was performed on the GGG of radical prostatectomies (RP).

Overall, 1805 consecutive patients undergoing RP for localized prostate cancer between 2007 and 2013 were included in the analysis. The primary endpoint was biochemical recurrence (BCR), defined as a PSA level of above 0.2 ng/ml, followed by a similar test result, or receiving salvage therapy. The authors performed multivariable Cox regression models to assess the predictive ability of the GGG of RPs.

Data was available on 1694 patients (94%). The distribution of patients was as follows:
  • GGG1 (n=531, 31.3%)
  • GGG2 (n=851, 50.2%)
  • GGG3 (=249, 14.7%)
  • GGG4 (n=38, 2.2%) 
  • GGG5 (n=25, 1.5%). 
The median follow-period was 48 months. The rates of five-year freedom from BCR for the GGG 1-5 are demonstrated in figure 1. It was clearly shown that higher GGG was correlated with increased risk of BCR (GGG2 to 3, hazard ratio [HR] 0.036; 95% confidence interval [CI] 0.26-0.49; p<0.0001).
UroToday CUA 2018 Kaplan Meier analysis for biochemical recurrence free survival

This report represents the first Canadian validation of the 2015 prostate cancer GGG system. The five-tier radical prostatectomy GGG system predicted cancer control outcome after surgery in a universal healthcare system.   

Presented by: Beech, Benjamin, University of Alberta, Edmonton, Canada
Co-Authors: Niels Jacobsen1, Sunita Ghosh2, Jan Rudzinski1, Ryan McLarty1, Nick Dean1, Steven Tong1, Dylan Hoare1, Adrian Fairey1.
Author Information:
1. Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
2. Department of Oncology, University of Alberta, Edmonton, AB, Canada

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan at the 73rd Canadian Urological Association Annual Meeting - June 23 - 26, 2018 - Halifax, Nova Scotia

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