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Eur Urol Oncol. 2019 May;2(3):333-336. doi: 10.1016/j.euo.2018.08.017. Epub 2018 Sep 13.

Consistent Biopsy Quality and Gleason Grading Within the Global Active Surveillance Global Action Plan 3 Initiative: A Prerequisite for Future Studies.

Author information

1
Department of Pathology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada. Electronic address: theodorus.vanderkwast@uhn.ca.
2
Department of Urology, Erasmus MC, Rotterdam, The Netherlands.
3
Department of Urology, Erasmus MC, Rotterdam, The Netherlands; Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
4
Johns Hopkins University, The James Buchanan Brady Urological Institute, Baltimore, MD, USA.
5
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
6
University of California San Francisco, San Francisco, CA, USA.
7
Emory University School of Medicine, Winship Cancer Institute, Atlanta, GA, USA.
8
MD Anderson Cancer Centre, Houston, TX, USA.
9
University of Michigan and Michigan Urological Surgery Improvement Collaborative, Michigan, USA.
10
University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
11
University of British Columbia, BC Cancer Agency, Vancouver, Canada.
12
University of Calgary, Southern Alberta Institute of Urology, Calgary, Canada.
13
University College London and University College London Hospital Trust, London, UK.
14
University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
15
King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK.
16
Guy's and St Thomas' NHS Foundation Trust, London, UK.
17
Erasmus Medical Center, Rotterdam, The Netherlands.
18
Lille University Hospital Center, Lille, France.
19
Helsinki University and Helsinki University Hospital, Helsinki, Finland.
20
Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Radiation Oncology 1 and Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
21
University College Dublin, Dublin, Ireland.
22
Sahlgrenska University Hospital, Göteborg, Sweden.
23
Instituto Valenciano de Oncología, Valencia, Spain.
24
Skåne University Hospital, Malmö, Sweden.
25
Kan-tonsspital Baden, Baden, Switzerland.
26
Singapore General Hospital, Singapore, Singapore.
27
Monash Health; Monash University, Melbourne, Australia.
28
Kagawa University Faculty of Medicine, Kagawa, Japan.
29
Gangnam Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.
30
Princess Margaret Cancer Centre, Toronto, Canada.
31
Royal Philips, Eindhoven, The Netherlands.
32
Cleveland Clinic, Cleveland, OH, USA.
33
University of Manchester, Manchester, UK.
34
Epworth HealthCare, Melbourne, Australia.
35
University of Michigan and Michigan Urological Surgery Improvement Collaborative, Ann Arbor, MI, USA.
36
King's College London, London, UK.
37
Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
38
Kantonsspital Baden, Baden, Switzerland.
39
Monash University and Epworth HealthCare, Melbourne, Australia.
40
Kagawa University, Kagawa, Japan.
41
Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
42
Erasmus MC, Rotterdam, The Netherlands.
43
University of Tampere, Tampere, Finland.
44
University of Toronto, Toronto, Canada.
45
The Hyve B.V. Utrecht, Utrecht, The Netherlands.
46
Johns Hopkins University, Baltimore, MD, USA.
47
Movember Foundation, Melbourne, Australia.

Abstract

Within the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative, 25 centers across the globe collaborate to standardize active surveillance (AS) protocols for men with low-risk prostate cancer (PCa). A centralized PCa AS database, comprising data of more than 15000 patients worldwide, was created. Comparability of the histopathology between the different cohorts was assessed by a centralized pathology review of 445 biopsies from 15 GAP3 centers. Grade group 1 (Gleason score 6) in 85% and grade group ≥2 (Gleason score ≥7) in 15% showed 89% concordance at review with moderate agreement (κ=0.56). Average biopsy core length was similar among the analyzed cohorts. Recently established highly adverse pathologies, including cribriform and/or intraductal carcinoma, were observed in 3.6% of the reviewed biopsies. In conclusion, the centralized pathology review of 445 biopsies revealed comparable histopathology among the 15 GAP3 centers with a low frequency of high-risk features. This enables further data analyses-without correction-toward uniform global AS guidelines for men with low-risk PCa. PATIENT SUMMARY: Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative combines data from 15000 men with low-risk prostate cancer (PCa) across the globe to standardize active surveillance protocols. Histopathology review confirmed that the histopathology was consistent with low-risk PCa in most men and comparable between different centers.

KEYWORDS:

Active surveillance; Biopsy quality; GAP3 consortium; Gleason grading; Pathology review; Prostate cancer

PMID:
31200849
DOI:
10.1016/j.euo.2018.08.017

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