The authors used the Fine and Gray proportional hazards model for subdistributions and the corresponding cumulative incidence to quantify the risk of PCSM. We found that the risk of PCSM approximately doubled with each GGG increase. Among men who underwent radical prostatectomy and using GGG1 (Gleason score ≤6) as the reference group, the adjusted hazard ratio for PCSM was 1.13 (95% confidence interval [CI] 0.83–1.54) for GGG2, 1.87 (95% CI 1.33–2.65) for GGG3, 5.03 (95% CI 3.59–7.06) for GGG4, and 10.92 (CI 8.03-14.84) for GGG5. Similar patterns were observed regardless of the type of primary cancer treatment received or clinical stage. In summary, our study, with large, racially diverse populations that reflect real world experiences, demonstrates that the new five-tiered GGG system predicts PCSM well regardless of treatment received or clinical stage at diagnosis.
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Our study used patients identified from 18 US cancer registries to validate a proposed five-tiered Gleason grade grouping (GGG) system. This is the first study to show that the five-tiered GGG system predicts prostate cancer–specific mortality well. European Association of Urology, Published by Elsevier B.V. DOI: 10.1016/j.eururo.2016.11.031
By: Jianming He 1, Peter C. Albertsen 2, Dirk Moore 3, David Rotter 4, Kitaw Demissie 5 and Grace Lu-Yao 6
1 The School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; Janssen Global Services LLC, Raritan, NJ, USA.
2 Department of Surgery (Urology), University of Connecticut Health Center, Farmington, CT, USA.
3 The School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; The Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
4 The Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
5 The School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
6 Department of Medical Oncology, Sidney Kimmel Medical College and Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA; Sidney Kimmel Cancer Center at Jefferson, Philadelphia, PA, USA.
Pub Med Abstract or Access European Urology