Clinical Factors Associated With Pathological Grade Group 1 Patients in D'Amico Intermediate-Risk Group Following Robot-Assisted Radical Prostatectomy: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group).

We aimed to examine the relationship between D'Amico intermediate-risk and pathological grade group 1 (pGG1) after robot-assisted radical prostatectomy (RARP).

In this retrospective multicenter cohort study, D'Amico intermediate-risk prostate cancer patients who did not receive neoadjuvant therapy, and underwent RARP at 10 institutions in Japan were examined for preoperative factors associated with pGG1.

In total, we enrolled 1161 D'Amico intermediate-risk prostate cancer patients. The pGG1 and pGG ≥2 groups comprised 73 (6.3%), and 1088 (93.7%) cases, respectively. Biochemical recurrence-free survival (BCRFS) of the pGG1 group was equivalent to that of the D'Amico low-risk patients. Among the 3 D'Amico intermediate-risk factors (IRF), the pGG1-rate was 24% with prostate-specific antigen (PSA) of 10 to 20 ng/mL alone, and 30% with cT2b alone. Both groups had significantly higher pGG1-rates than other groups. Down-grading from biopsy GG ≥2 to pGG1 was relatively rare (3.9%). Patients with pGG1 were further stratified by prostate volume (PV) (cutoff, 40 cc) among patients with one IRF and PSA of 10 to 20 ng/mL. Patients with one IRF, PSA of 10 to 20 ng/mL, and PV >40 cc had a relatively good BCRFS similar to that of the D'Amico low-risk group.

Among intermediate-risk prostate cancer patients, those with pGG1 have a good prognosis. Downgrading from biopsy GG ≥2 is rare, and definitive treatment may be recommended for patients with biopsy GG ≥2. Patients with one IRF, PSA of 10 to 20 ng/mL, and PV >40 cc who are eligible for RARP may be candidates for active surveillance.

Clinical genitourinary cancer. 2022 Jun 09 [Epub ahead of print]

Yusuke Sugino, Takeshi Sasaki, Shin Ebara, Tomoyuki Tatenuma, Yoshinori Ikehata, Akinori Nakayama, Makoto Kawase, Masahiro Toide, Tatsuaki Yoneda, Kazushige Sakaguchi, Jun Teishima, Kazuhide Makiyama, Hiroshi Kitamura, Kazutaka Saito, Takuya Koie, Fumitaka Koga, Shinji Urakami, Takahiro Inoue

Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Mie, Japan., Department of Urology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan., Department of Urology, Yokohama City University, Yokohama, Japan., Department of Urology, University of Toyama, Toyama, Japan., Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan., Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan., Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan., Department of Urology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan., Department of Urology, Toranomon Hospital, Tokyo, Japan., Department of Urology, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan., Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Mie, Japan. Electronic address: .

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