ArticleThe Journal of urology2025
The Absolute Volume of Gleason Pattern 4 on Radical Prostatectomy Is More Strongly Associated With Advanced Stage and Biochemical Recurrence Than Gleason Grade Groups.
Article in The Journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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.
Who cites it
3 citing papers in PubMed.
- Comparing Gleason Pattern 4 Measurement Approaches on Prostate Biopsy Using Machine Learning: A Proof-of-Principle Study.medRxiv : the preprint server for health sciences · 2026Article
- Development and validation of a novel clinical-radiological-pathological scoring system for preoperative prediction of extraprostatic extension in prostate cancer: a multicenter retrospective study.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Article
- Prognostic impact of extraprostatic extension on prostate cancer with seminal vesicle invasion.American journal of clinical and experimental urology · 2025Article
Corrections and comments
- Commented on by
Authors and funding
15 authors.
Funding
Abstract
purposeInternational Society of Urological Pathology (ISUP) Grade Group (GG) is based on the relative proportion of Gleason patterns 3 and 4. We investigated whether absolute pattern 4 volume is more strongly associated with advanced stage and biochemical recurrence than GG in patients with pattern 4 but not 5. MATERIALS AND
methodsOverall, 1171 men received radical prostatectomy. Advanced stage definitions were extraprostatic extension (EPE) or seminal vesicle invasion (SVI) or lymph nodal invasion (LNI), and SVI or LNI. We explored the association between pattern 4 volume and percentage, and GG with advanced stage and recurrence using logistic and Cox regressions. We examined whether incorporating pattern 4 percentage improved the accuracy of a model including pattern 4 volume, PSA, and cT stage.
resultsOverall, 649, 381, and 141 patients had GG2, GG3, and GG4. EPE, SVI, and LNI were in 643, 84, and 57 men. For the EPE, SVI, or LNI outcome, pattern 4 volume showed higher discrimination (0.748) than ISUP (0.693) and pattern 4 percentage (0.724). Results were strengthened when outcome was SVI or LNI and excluded patients without nodal dissection. Pattern 4 volume showed higher discrimination for recurrence (0.705) than ISUP (0.675) or pattern 4 percentage (0.680). Pattern 3 volume did not increase discrimination when added to pattern 4. PSA levels were driven by pattern 4 volume, with pattern 3 and benign volumes having less impact.
conclusionsThe total amount of pattern 4 provides superior prognostic information to the relative proportion of patterns 3 and 4. Further research should investigate the best pattern 4 quantification method.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.