{
  "abstract": "Background/aim\n\nThis study aimed to identify pre-treatment predictors of Gleason score (GS) upgrading in patients with biopsy-confirmed Grade Group 1 (GS 3+3) prostate cancer (PCa) - those typically considered candidates for active surveillance according to National Comprehensive Cancer Network guidelines - so as to refine risk stratification and avoid under-treatment.Patients and methods\n\nA retrospective analysis was conducted on patients with biopsy-proven GS 3+3 PCa who underwent radical prostatectomy (RP) at a tertiary referral center between 2010 and 2023. Preoperative clinical, pathological, and biochemical data were collected, including prostate-specific antigen (PSA) levels, PSA density, prostate volume (PV). Multivariable logistic regression was used to identify independent predictors of GS upgrading. Collinearity among PSA, PV, and PSA density was assessed using variance inflation factors and correlation matrix analysis.Results\n\nAmong the 121 patients included in the study, 64.46% experienced GS upgrading at the final pathology. Patients with GS upgrading were older (median age 67.5 years), had higher PSA density (median 0.3 ng/ml/cm³ vs. 0.18 ng/ml/cm³, p=0.0033), and exhibited a smaller median PV (36.4 ml vs. 41 ml, p=0.0145) compared to those without upgrading. These findings highlight the limitations of biopsy-based grading in accurately assessing tumor aggressiveness.Conclusion\n\nGS upgrading is common in patients initially diagnosed with GS 3+3 PCa and is associated with pre-treatment clinical factors, including PSA density and smaller PV. Identifying these predictors preoperatively may improve risk stratification and guide personalized treatment strategies. Future research should focus on integrating genomic and molecular markers to increase the predictive accuracy and optimize patient management.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.",
    "Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C.",
    "Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.",
    "Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hsiao-Chun Su"
    },
    {
      "affs": [
        1
      ],
      "name": "Yung-Chun Su"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Hsiang-Ying Lee"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Yung-Shun Juan"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Wen-Jeng Wu"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Kevin Lu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b45xpa3p7qkdr.bib",
  "cited_by": 0,
  "doi": "10.21873/cdp.10603",
  "fulltext_url": "https://europepmc.org/articles/PMC13724023",
  "id": "b45xpa3p7qkdr",
  "issns": [
    "2732-7787"
  ],
  "landing_url": "https://europepmc.org/article/MED/42968951",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2740|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7225113523",
  "pdf_url": "https://europepmc.org/articles/PMC13724023?pdf=render",
  "pmcid": "PMC13724023",
  "pmid": "42968951",
  "published": "2026-11-01",
  "publisher": "International Institute of Anticancer Research",
  "ris": "https://research.draconitic.com/paper/b45xpa3p7qkdr.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:53Z",
      "native_id": "MED:42968951",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42968951"
    },
    {
      "first_seen": "2026-11-04T12:22:33Z",
      "native_id": "PMC13724023",
      "source": "pmc",
      "url": "https://doi.org/10.21873/cdp.10603"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Prostate Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "From Biopsy to Pathology: A Retrospective Cohort Study of Predictors of Gleason Score Upgrading in Grade Group 1 Prostate Cancer.",
  "title_text": "From Biopsy to Pathology: A Retrospective Cohort Study of Predictors of Gleason Score Upgrading in Grade Group 1 Prostate Cancer.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:44Z",
  "url": "https://research.draconitic.com/paper/b45xpa3p7qkdr",
  "venue": "Cancer diagnosis & prognosis",
  "versions": []
}