“Grade group (GG) 1 prostate cancer is considered low-risk based on its non-aggressive clinical course for the majority of patients,” says urologist Nirmish Singla, M.D. “However, there is an uncommon subset of these low-grade tumors that is capable of invading through the capsule of the prostate.”

What happens when these low-risk tumors poke outside the prostate (this is called extraprostatic extension, or EPE)? In a recent study, published in the Journal of Urology, former Brady urologic oncology fellow Michael Rezaee, M.D., and colleagues looked at the data on patients who under- went radical prostatectomy at the Brady between 2005 and 2022. “We found that among patients undergoing radical prostatectomy for GG1 prostate cancer, there were no differences in biochemical recurrence by the presence or absence of EPE,” says Singla, the study’s senior author. However, for patients with GG2 disease who had EPE, biochemical recurrence (the return of PSA) was more likely.

“Our findings are reassuring,” says Singla, “affirming that GG1 prostate cancer is a low-risk disease – even when tumors invade beyond the prostate. However, future research is needed to understand how EPE may influence the natural history of GG1 tumors on active surveillance.”