Fig 1.
Study diagram and patient selection criteria.
Fig 2.
(A) Fused glands (400x). In the original Gleason grading this pattern was considered pattern 3. According to the 2005 ISUP Gleason system it would be graded as pattern 4; B) Adenocarcinoma with glomeruloid features currently assigned a Gleason pattern 4 (100x); C) Ill-defined glands (100x). This pattern would be graded as Gleason pattern 4 by the ISUP 2005 Gleason grading; and D) Individual cells (100x).
This pattern was originally accepted under Gleason pattern 3 and would be assigned a Gleason pattern 5 according to the 2005 ISUP Gleason system.
Table 1.
Cohort Demographic and Clinical Characteristics.
Fig 3.
Cumulative incidence of metastasis at 5 years post radical prostatectomy.
A) Difference in re-graded 2005 ISUP modified and original Gleason score; B) Difference in primary re-graded 2005 ISUP modified and original Gleason score; and C) Difference in secondary re-graded 2005 ISUP modified and original Gleason score.
Table 2.
Changes in regraded variables compared to original variables by oncologic outcome.
Fig 4.
Cumulative incidence curves of A) metastasis by original Gleason score, B) metastasis by reviewed Gleason score.
The number at risk in each group is shown in the footnote lines. Patients in the sub-cohort who do not experience the event are weighted by the inverse of the sampling fraction in following the case-cohort design.
Table 3.
Univariable and Multivariable Cox proportional hazards analysis of risk factors using original and ISUP regraded GS.
Fig 5.
A) Survival concordance index. Reviewed Gleason score by the 2005 ISUP modified Gleason system has the highest c-index compared to original Gleason score. B) Decision curve analysis at 5 years post radical prostatectomy shows the net benefit of original and reviewed Gleason score across probability thresholds.
The reviewed Gleason score shows the highest net benefit.
Table 4.
Multivariable Cox proportional hazards analysis of Decipher adjusting for original and ISUP regraded GS.