{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T11:35:48Z","timestamp":1763552148392,"version":"3.37.3"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T00:00:00Z","timestamp":1638921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000109","name":"Prostate Cancer Canada","doi-asserted-by":"publisher","award":["D2017\u20101879"],"award-info":[{"award-number":["D2017\u20101879"]}],"id":[{"id":"10.13039\/501100000109","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To validate the importance of recently established adverse histopathology features (cribriform pattern and intraductal carcinoma) as contra\u2010indication for deferred treatment of Gleason score 7 (3\u2009+\u20094) (grade group [GG] 2) prostate cancer, we investigated their frequency in GG2 radical prostatectomies with syn\u2010 or metachronous metastatic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>GG2 prostatectomy specimens of patients with concomitant lymph node metastasis or distant metastasis at follow\u2010up were identified in a clinical database of a tertiary care center and their pathology was reviewed for pathological stage, lymphovascular invasion, Gleason grade 4 subpatterns, presence of tertiary grade 5, and ductal adenocarcinoma histology. A control group of 99 GG2 prostatectomy specimens who had no metastatic disease (controls) was reviewed for the same adverse pathological features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1860 GG2 prostatectomy specimens (operated between 2002 and 2020), 45 (2.4%) had concurrent regional lymph node metastases or distant metastases at follow\u2010up. Pathological stage distribution of cases and controls was 24% and 79% pT2, 42% and 15% pT3a, 33% and 6.1% pT3b \u2010T4, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Eleven of 45 cases (24%) had \u226410% Gleason grade 4 component. Cribriform pattern or intraductal carcinoma was present in 84% of cases versus 34% of controls (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), tertiary grade 5 in 16% of cases versus 5% controls (<jats:italic>p<\/jats:italic>\u2009=\u20090.05) and ductal adenocarcinoma in 16% of cases versus 2% of controls (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). Among the seven cases without cribriform or intraductal carcinoma, two displayed ductal adenocarcinoma features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Well\u2010established unfavorable histopathologic features (intraductal and cribriform pattern carcinoma, ductal adenocarcinoma) are represented in about 90% of GG2 prostate cancers with local or distant metastatic disease and are much less common (38%) in those without metastatic disease. Strikingly, about 25% of GG2 prostatectomy cases with metastatic disease had an organ\u2010confined disease and\/or a small percentage of Gleason grade 4 pattern. This further emphasizes the relative importance of these adverse histopathological features (cribriform, intraductal, and ductal adenocarcinoma) rather than percentage Gleason grade 4 as contra\u2010indicator of deferred treatment for patients with GG2 prostate cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.24279","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T11:11:24Z","timestamp":1638961884000},"page":"345-351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of adverse pathology features in grade group 2 prostatectomy specimens with syn\u2010 or metachronous metastatic disease"],"prefix":"10.1002","volume":"82","author":[{"given":"Christopher","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Pathology, Laboratory Medicine Program, Anatomic Pathology University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Downes","sequence":"additional","affiliation":[{"name":"Department of Pathology, Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahi","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Hospital Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Ientilucci","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Fleshner","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Perlis","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8640-5786","authenticated-orcid":false,"given":"Theodorus","family":"van der Kwast","sequence":"additional","affiliation":[{"name":"Department of Pathology, Laboratory Medicine Program, Anatomic Pathology University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2020.03.002"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13623"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2012-0128-OA"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14935"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000671"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2014.116"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2012.02.003"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2016.49"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2016.12.008"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0121-8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000173646.99337.b1"},{"volume-title":"UICC International Union Against Cancer","year":"2017","author":"Brierley JD","key":"e_1_2_9_13_1"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0157-9"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13767"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-013-1385-5"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31820eb25b"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3182556dcd"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12879"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djt151"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2013.112"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2020.03.002"},{"key":"e_1_2_9_23_1","unstructured":"European Association of Urology Guideline. 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