Mortality Risk High for Some Gleason Grade 1 Prostate Cancer Patients

THURSDAY, Aug. 1, 2024 (HealthDay News) -- For patients with Gleason Grade Group (GGG) 1 prostate cancer (PC), those with percentage positive biopsies (PPB) >50 percent or prostate-specific antigen (PSA) >20 ng/mL have a significantly increased risk for adverse outcomes, according to a study published online July 2 in European Urology Oncology.

Derya Tilki, M.D., from University Hospital Hamburg-Eppendorf in Germany, and colleagues examined the association of clinical factors at presentation with the presence of unsampled high-risk PC and PC-specific mortality (PCSM) and all-cause mortality following radical prostatectomy in a study population composed of 10,228 patients treated for GGG1 PC diagnosed via transrectal ultrasound-guided systematic biopsy (SBx) or combined biopsy (CBx).

The researchers found that PPB >50 percent and PSA >20 ng/mL were significantly associated with a higher risk for adverse pathology, regardless of biopsy approach (SBx: adjusted odds ratios [aORs], 1.71 and 3.49; CBx: aORs, 1.81 and 2.82, respectively) and with early PSA failure (SBx: adjusted hazard ratios [aHRs], 1.54 and 4.37; CBx: aHRs, 2.88 and 7.81, respectively). In the SBx group, PPB >50 percent and PSA >20 ng/mL were also associated with a higher risk for PCSM (aHRs, 2.56 and 3.71, respectively) and with all-cause mortality (aHRs, 1.47 and 2.00, respectively).

"For patients with GGG1 who are at heightened risk, we should continue to call their diagnosis cancer and we should report it back to their physician so that they can act on this information," senior author Anthony V. D'Amico, M.D., Ph.D., from Brigham and Women's Hospital in Boston, said in a statement.

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