Intermediate-Risk Prostate Cancer Varies in Prognosis

Intermediate-risk prostate cancer (PCa) can be favorable or unfavorable in terms of biochemical outcomes following radical prostatectomy (RP), a new study suggests.

Patients with favorable intermediate-risk PCa have a significantly higher 5-year biochemical recurrence (BCR)-free survival rate compared with those who have unfavorable intermediate-risk PCa (87.5% vs. 66.5%), according to a report published online ahead of print in BJU International. 

In addition, the study found that patients with unfavorable intermediate-risk PCa had a significantly higher 5-year BCR-free survival rate than those with high-risk PCa (66.5% vs. 47.9%). The favorable intermediate-risk group had a significantly lower 5-year BCR-free survival rate than men with low-risk disease (87.5% vs. 93.5%).

The researchers concluded that intermediate-risk PCa should be stratified further into favorable and unfavorable disease subgroups. A more precise characterization of disease using such a stratification system “would contribute to the more appropriate management of intermediate-risk PCa,” they concluded.

Jin-Woo Jung, MD, and colleagues at Seoul National University Bundang Hospital in Seongnam, Korea, reviewed data from 1,559 men who underwent RP from 2005 to 2013 and classified them according to National Comprehensive Cancer Network risk groups. Of these patients, 568 (36.4%) had low-risk PCa (clinical stage T1–T2a, biopsy Gleason score 6 or less, and PSA less than 10 ng/mL); 556 (35.7%) had intermediate-risk disease (clinical stage T2b – T2c, biopsy Gleason score 7, or PSA 10–20 ng/mL); and 343 (22%) had high-risk PCa (clinical stage T3a, biopsy Gleason score 8–10, or PSA greater than 20 ng/mL).

The researchers designated intermediate-risk PCa as unfavorable if it met at least 1 of the following 2 criteria: biopsy Gleason score 4 + 3 and/or presence of 2 or more intermediate-risk criteria. All other men with intermediate-risk PCa were designated as having favorable intermediate-risk disease.

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