Evidence map›Paper›PMID 31768317›Full record

ArticleAsian journal of urology2019

Extent and predictors of grade upgrading and downgrading in an Australian cohort according to the new prostate cancer grade groupings.

Kerri Beckmann, Michael O'Callaghan, Andrew Vincent, Penelope Cohen, Martin Borg, David Roder, Sue Evans, Jeremy Millar, Kim Moretti

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Asian journal of urology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Kerri BeckmannCancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, Australia.
Michael O'CallaghanFlinders Medical Centre, Urology Unit, Adelaide, Australia.
Andrew VincentSchool of Medicine, University of Adelaide, Adelaide, Australia.
Penelope CohenSA Pathology, Health SA, Adelaide, South Australia, Australia.
Martin BorgGenesis Care, University of Adelaide, Adelaide, Australia.
David RoderCancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, Australia.
Sue EvansDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Jeremy MillarDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Kim MorettiCancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, Australia.
University of Adelaide · AUUniversity of South Australia · AUMonash University · AUSouth Australia Pathology · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectTo determine the extent and impact of upgrading and downgrading among men who underwent radical prostatectomy (RP) according to new grade groupings and to identify predictors of upgrading from biopsy grade Group I and II, and downgrading to grade Group I, in a community setting.

methodsStudy participants included 2279 men with non-metastatic prostate cancer diagnosed 2006-2015 who underwent prostatectomy, from the multi-institutional South Australia Prostate Cancer Clinical Outcomes Collaborative registry. Extent of up- or down-grading was assessed by comparing biopsy and prostatectomy grade groupings. Risk of biochemical recurrence (BCR) with upgrading was assessed using multivariable competing risk regression. Binomial logistic regression was used to identify pre-treatment predictors of upgrading from grade Groups I and II, and risk group reclassification among men with low risk disease.

resultsUpgrading occurred in 35% of cases, while downgrading occurred in 13% of cases. Sixty percent with grade Group I disease were upgraded following prostatectomy. Upgrading from grade Group I was associated with greater risk of BCR compared with concordant grading (Hazard ratio: 3.1, 95% confidence interval: 1.7-6.0). Older age, higher prostate-specific antigen levels (PSA), fewer biopsy cores, higher number of positive cores and more recent diagnosis predicted upgrading from grade Group I, while higher PSA and clinical stage predicted upgrading from grade Group II. No clinical risk factors for reclassification were identified.

conclusionBiopsy sampling errors may play an important role in upgrading from grade Group I. Improved clinical assessment of grade is needed to encourage greater uptake of active surveillance.

Indexed as

BiopsyGrade misclassificationPathologyProstate cancerRadical prostatectomy

Identifiers

PMID31768317
PMCPMC6872773
OpenAlexW2921205674

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.