Evidence map›Paper›PMID 41293883›Full record

Trial reportHistopathology2026

Rethinking Gleason pattern quantification in predicting metastasis: results of 20 years of follow-up in the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer.

Lisa J Kroon, Sebastiaan Remmers, Ivo I de Vos, Charlotte F Kweldam, L Lucia Rijstenberg, Roderick C N van den Bergh, Monique J Roobol, Geert J L H van Leenders

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Histopathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

8 authors.

Lisa J KroonDepartment of Pathology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands.ORCID https://orcid.org/0009-0003-6801-3633
Sebastiaan RemmersDepartment of Urology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0001-9530-6448
Ivo I de VosDepartment of Urology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0001-9000-7457
Charlotte F KweldamDepartment of Pathology, Maasstad Hospital, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0002-1581-9612
L Lucia RijstenbergDepartment of Pathology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0001-6672-1343
Roderick C N van den BerghDepartment of Urology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0002-2605-2453
Monique J RoobolDepartment of Urology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0001-6967-1708
Geert J L H van LeendersDepartment of Pathology, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0003-2176-9102

Funding

Jaap Schouten Foundation
6 · The paper itself

Abstract

introductionThe Gleason grading system for prostate cancer (PCa) is based on the proportions of Gleason patterns (GP) 3-5. While pure GP3 has minimal metastatic potential, it is unclear whether GP3 quantity in the presence of GP4 and GP5 affects oncological outcomes.

objectiveTo assess the predictive value of PCa biopsy GP lengths on long-term metastasis-free survival (MFS).

methodsProstate biopsies of 1,881 men with screen-detected PCa who participated in the Dutch part of the European Randomized Study of Screening for Prostate Cancer (ERSPC) between 1993 and 2007 were revised for GP 3-5 length. Multivariable Cox regression analyses were used to evaluate the relationship between GP lengths and MFS truncated at 20 years, adjusting for clinical-tumour stage (cT), prostate-specific antigen (PSA), percentage positive biopsies and the presence of invasive cribriform/intraductal carcinoma (CR/IDC). RESULTS AND LIMITATIONS: On multivariable analysis, ≥cT2, PSA, percentage positive cores and absolute length of GP4 and GP5 were all significantly associated with MFS. The discriminative ability was improved by adding CR/IDC to the model. Total GP3 length was neither associated with MFS in the model with (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.97-1.00, P = 0.3) nor without CR/IDC (HR 0.98, 95% CI 0.96-1.01, P = 0.2). A limitation is the lack of targeted biopsies. CONCLUSION AND CLINICAL IMPLICATIONS: GP3 length does not have an impact on the prediction of MFS in biopsies, once GP4/GP5 lengths are known. Although GP3 percentage is essential in Gleason grading, MFS is related to absolute GP4 and GP5 quantity rather than their proportion to GP3.

Indexed as

Neoplasm GradingProstatic NeoplasmsAgedDisease-Free SurvivalEarly Detection of CancerFollow-Up StudiesHumansMaleMiddle AgedNeoplasm MetastasisPrognosisProstate-Specific AntigenProstate-Specific AntigenGleason scoremetastasisneedle biopsyprostate cancerquantitative Gleason grade

Identifiers

PMID41293883
PMCPMC12891930

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Registered trials

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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.