{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T20:27:49Z","timestamp":1783024069425,"version":"3.54.6"},"reference-count":11,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Grade Group (GG) 1 disease is known to have low metastatic potential, but in the D'Amico risk stratification systems a GG1 tumor with prostate\u2010specific antigen (PSA) of 10\u201320\u2009ng\/mL qualifies as intermediate risk (IR). We hypothesized that GG1 tumors are heterogenous and evaluated oncologic outcomes after prostatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of men undergoing robot\u2010assisted radical prostatectomy (RARP) from July 2003 to June 2023. Patients met FIR criteria if biopsy results were GG1 with PSA 10\u201320\u2009ng\/mL (GG1\u2010FIR), or if biopsy GG2 was the only IR feature (GG2\u2010FIR). Primary endpoints were overall survival (OS); secondary endpoints were biochemical recurrence\u2010free survival (BCRFS), postoperative upgrading, and time to radiotherapy. Analyses utilized Kaplan\u2013Meier estimates with Cox models to compare outcomes between the FIR subgroups. Sensitivity analyses compared FIR subgroups with a low\u2010risk cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 2703 patients undergoing RARP, 553 (13.4%) met FIR criteria with 103 (18.6%) being GG1\u2010FIR and 450 (81.4%) GG2\u2010FIR. The primary analysis showed no difference in long\u2010term oncologic outcomes. At 10 years, OS was 80.9% for GG1\u2010FIR and 81.5% for GG2\u2010FIR, declining to 62.2% and 69.5%, at 15 years (HR\u2009=\u20090.8, 95% CI 0.5\u20131.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.63). BCRFS at 10 and 15 years was 87.5% and 84.2% for GG1\u2010FIR vs. 89.8% and 81.2% for GG2\u2010FIR (HR\u2009=\u20090.7, 95% CI 0.3\u20131.7;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.54). Time to radiotherapy was comparable (HR\u2009=\u20090.70, 95% CI 0.36\u20131.33;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.27). Upstaging, or pathologic \u2265pT3 rates, were 24.3% vs. 30.4% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.21) and nodal positivity 3.3% vs. 2.1% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.64). In sensitivity analyses, GG1\u2010FIR had similar OS (HR\u2009=\u20091.60, 95% CI 0.94\u20132.70) but worse BCRFS (HR\u2009=\u20092.56, 95% CI 1.22\u20135.38) compared with 1242 low\u2010risk patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with FIR tumors had similar long\u2010term oncologic outcomes after RARP. However, GG1 tumors behaved differently across the PSA spectrum. When PSA is high, outcomes mirror clinically significant disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70199","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T18:10:58Z","timestamp":1779819058000},"page":"1195-1201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcome Differences Between Subgroups of Favorable Intermediate Risk Prostate Cancer After Radical Prostatectomy"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6651-2189","authenticated-orcid":false,"given":"Matthew T.","family":"Steidle","sequence":"first","affiliation":[{"name":"Department of Urology University of Rochester Medical Center Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4130-8987","authenticated-orcid":false,"given":"Kamil","family":"Malshy","sequence":"additional","affiliation":[{"name":"Department of Urology University of Rochester Medical Center Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4090-7585","authenticated-orcid":false,"given":"Zijing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Urology University of Rochester Medical Center Rochester New York USA"},{"name":"Department of Public Health Sciences, Division of Health Policy and Outcomes Research University of Rochester Medical Center Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denzel","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Urology University of Rochester Medical Center Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2439-7578","authenticated-orcid":false,"given":"Trevor C.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Urology University of Rochester Medical Center Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jathin","family":"Bandari","sequence":"additional","affiliation":[{"name":"Department of Urology University of Rochester Medical Center Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean V.","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Urology University of Rochester Medical Center Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.10.057"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.22.00123"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/pas.0b013e3182556dcd"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002757"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2023.12.005"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0025-6196(12)61614-0"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-005-0029-y"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20243"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2007.08.055"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11324.x"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.08.052"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pros.70199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T20:00:19Z","timestamp":1783022419000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.70199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":11,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/pros.70199"],"URL":"https:\/\/doi.org\/10.1002\/pros.70199","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"2026-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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