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Peer-reviewedCC BY 4.0Prostate Cancer and Prostatic Diseases

Long-term oncologic outcomes of patients with grade group 1 prostate cancer and pT3a disease on final pathology

  • Mohamad Watfa1
  • Kristina Dortche1
  • Gagan Fervaha1
  • Salim K. Younis1
  • Abdulrahman Al-Bayati1
  • Betty Wang1
  • Rui M. Bernardino1
  • Jesse K. McKenney1,2
  • Samuel Haywood1
  • Ruben Olivares1
  • Riccardo Autorino1
  • Jihad Kaouk1
3 more authors
  • Christopher J. Weight1
  • Zeyad R. Schwen1
  • Jane K. Nguyen1,2
  1. 1Glickman Urological Institute, Cleveland Clinic, Cleveland, OH USA
  2. 2Diagnostics Institute, Anatomic Pathology, Cleveland Clinic, Cleveland, OH USA
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Abstract

Background: Grade Group 1 (GG1) prostate cancer is biologically indolent and typically managed with active surveillance (AS), yet pT3a pathology is occasionally identified at radical prostatectomy (RP). Its prognostic significance in GG1 disease remains incompletely defined.

Methods: Retrospective cohort of 40 patients with GG1 and pT3a disease on RP (2000–2022), confirmed on central pathologic re-review.

Results: Four patients developed biochemical recurrence (BCR); the cumulative incidence of BCR was 3.2% at 5 years and 10.3% at 15 years. No patient developed metastatic disease or prostate cancer–specific mortality.

Conclusions: GG1 pT3a prostate cancer demonstrates excellent long-term outcomes. Adverse histologic features, not pathological stage alone, drive clinically meaningful risk. Late, stable PSA detectability alone does not signify meaningful recurrence.

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Cite

BibTeXRIS
BibTeX
@article{watfa2026longterm,
  title = {{Long-term oncologic outcomes of patients with grade group 1 prostate cancer and pT3a disease on final pathology}},
  author = {Mohamad Watfa and Kristina Dortche and Gagan Fervaha and Salim K. Younis and Abdulrahman Al-Bayati and Betty Wang and Rui M. Bernardino and Jesse K. McKenney and Samuel Haywood and Ruben Olivares and Riccardo Autorino and Jihad Kaouk and Christopher J. Weight and Zeyad R. Schwen and Jane K. Nguyen},
  journal = {Prostate Cancer and Prostatic Diseases},
  year = {2026},
  month = jul,
  doi = {10.1038/s41391-026-01138-z},
  url = {https://doi.org/10.1038/s41391-026-01138-z},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Long-term oncologic outcomes of patients with grade group 1 prostate cancer and pT3a disease on final pathology
AU  - Mohamad Watfa
AU  - Kristina Dortche
AU  - Gagan Fervaha
AU  - Salim K. Younis
AU  - Abdulrahman Al-Bayati
AU  - Betty Wang
AU  - Rui M. Bernardino
AU  - Jesse K. McKenney
AU  - Samuel Haywood
AU  - Ruben Olivares
AU  - Riccardo Autorino
AU  - Jihad Kaouk
AU  - Christopher J. Weight
AU  - Zeyad R. Schwen
AU  - Jane K. Nguyen
PY  - 2026
DA  - 2026/07/17
JO  - Prostate Cancer and Prostatic Diseases
DO  - 10.1038/s41391-026-01138-z
UR  - https://doi.org/10.1038/s41391-026-01138-z
AB  - Background: Grade Group 1 (GG1) prostate cancer is biologically indolent and typically managed with active surveillance (AS), yet pT3a pathology is occasionally identified at radical prostatectomy (RP). Its prognostic significance in GG1 disease remains incompletely defined.  Methods: Retrospective cohort of 40 patients with GG1 and pT3a disease on RP (2000–2022), confirmed on central pathologic re-review.  Results: Four patients developed biochemical recurrence (BCR); the cumulative incidence of BCR was 3.2% at 5 years and 10.3% at 15 years. No patient developed metastatic disease or prostate cancer–specific mortality.  Conclusions: GG1 pT3a prostate cancer demonstrates excellent long-term outcomes. Adverse histologic features, not pathological stage alone, drive clinically meaningful risk. Late, stable PSA detectability alone does not signify meaningful recurrence.
SN  - 1365-7852
SN  - 1476-5608
ER  -