Higher-Risk Disease Found in Men with Low-Risk Prostate Cancer

Strategic Insights -

A new study has found that a proportion of men with low-risk prostate cancer, specifically grade group 1 (GG1), have a higher-risk disease than previously suggested by biopsy. The study, published in JAMA Oncology, used data from over 117,000 men with localized GG1 prostate cancer and found that 60% of those with high-risk GG1 had adverse pathology at prostatectomy. This means that despite being classified as low-risk, some men may be at a higher risk of cancer-specific mortality.

Key Takeaways:

  • The study found that 9.3% of men with GG1 prostate cancer had unfavorable intermediate-risk disease, 4% had high-risk disease, and 20% had favorable intermediate-risk disease.
  • The researchers found that 60% of men with high-risk GG1 prostate cancer had adverse pathology at prostatectomy.
  • The study found that the prostate cancer-specific mortality rates were 2.4% and 4.7% for unfavorable intermediate-risk GG1 and high-risk GG1, respectively.
  • The researchers found that men with GG1 prostate cancer were at increased risk for prostate cancer-specific mortality compared to low-risk GG1, with an adjusted hazard ratio of 1.60 for favorable intermediate-risk GG1 and 3.58 for high-risk GG1.
  • The study's findings suggest that some men with low-risk GG1 prostate cancer may benefit from a more nuanced approach to risk assessment and treatment planning.

Statistics:

  • 117,162 men with localized GG1 prostate cancer were included in the study.
  • 9.3% (11,006 men) had unfavorable intermediate-risk disease.
  • 4% (4,688 men) had high-risk disease.
  • 20% (23,324 men) had favorable intermediate-risk disease.
  • 60% (epoch 10,650) of men with high-risk GG1 had adverse pathology at prostatectomy.
  • Prostate cancer-specific mortality rates were 2.4% and 4.7% for unfavorable intermediate-risk GG1 and high-risk GG1, respectively.

Sources:

  • Neal A. Patel, MD, et al. "Association of Biopsy Risk Groups With Cancer-Specific Outcomes After Prostatectomy Among Men With Grade Group 1 Prostate Cancer." JAMA Oncology, doi: 10.1001/jamaoncol.2025.3702