Included studies: patient demographic and clinical factors
| Authors | Year | Study design | Participants | Study outcomes associated with Gleason upgrading |
|---|---|---|---|---|
| Leeman et al. [16] | 2019 | Retrospective cohort | 3,571 men with GS6 prostate cancer (PCa) | Older age |
| Gershman et al. [17] | 2013 | Retrospective cohort | 1,836 men with GS6 on prostate biopsy | Older age, lower prostate weight, and PSA |
| Epstein et al. [18] | 2012 | Retrospective cohort | 7,643 totally embedded RP and corresponding needle biopsies | Older age, decreasing RP weight, PSA, and increasing maximum percentage cancer/core |
| Mazzone et al. [19] | 2021 | Retrospective case-control | 424 men with systematic + targeted biopsy and subsequent RP | Age was not associated |
| Vora et al. [20] | 2013 | Retrosepective case-control | 959 patients with D’Amico low-risk PCa who underwent RP | BMI, African American race, percent of core involved with cancer, increasing CAPRA score, and serum PSA |
| Freedland et al. [21] | 2007 | Retrospective cohort | 1,113 patients treated with RP from 1996 to 2005 within the Shared Equal Access Regional Cancer Hospital (SEARCH) database who had undergone at least sextant biopsy | Greater PSA, more biopsy cores with cancer, obesity, obtaining less than 8 biopsy cores |
| Zheng et al. [22] | 2023 | Retrospective case-control | 496 patients who underwent COG-TB and RP | Age, prostate volume, BMI, tumor percentage in biopsy, tumor location |
| Sundi et al. [26] | 2013 | Retrospective cohort | 1,801 men for met NCCN criteria for very low-risk PCa and underwent RP | African American race, positive surgical margins, and higher CAPRA-S score |
| Yang et al. [27] | 2019 | Retrospective cohort | 10,089 patients in the NCDB diagnosed from 2010 to 2012 with Gleason 3+4 disease, prostate-specific antigen < 10 mg/mL, and cT1c-2a PCa with < 50% positive biopsy cores | PSA, percentage PBC, age, cT2a versus cT1c, but not black race |
| Dinh et al. [28] | 2015 | Retrospective cohort | 10,273 patients in the SEER database diagnosed with clinically low risk disease (cT1c/T2a, PSA less than 10 ng/mL, Gleason 3 + 3 = 6) in 2010 to 2011 and treated with prostatectomy | Age, PSA, percent positive cores but not race |
| Uzzo et al. [30] | 1995 | Retrospective case-control | 1,021 transrectal TRUS-guided sextant pattern prostate biopsies with corresponding RP pathology | Higher prostate gland size |
| Kulkarni et al. [31] | 2006 | Retrospective cohort | 369 TRUS-guided biopsies of men with PCa with PSA less than 10 ng/mL | Higher TRUS prostate size |
| Kim et al. [32] | 2013 | Retrospective case-control | 451 patients with PCa with a GS of 6 on biopsy, who underwent RP without neoadjuvant treatment | Smaller prostate volume |
| Davies et al. [33] | 2011 | Retrospective case-control | 1,251 consecutive patients with D’Amico low risk disease available underwent RP | Smaller prostate volume |
| Pierorazio et al. [34] | 2007 | Retrospective case-control | 2,600 patients who had undergone RP from 1988 to 2006 | Smaller prostate volume, PSA, and age |
| Freedland et al. [35] | 2005 | Retrospective cohort | 1,602 men treated with RP between 1988 and 2003 at five equal-access medical centers, which composed the SEARCH database | Smaller prostate volume |
PSA: prostate-specific antigen; RP: radical prostatectomy; BMI: body mass index; TRUS: transrectal ultrasound; NCCN: National Comprehensive Cancer Network; CAPRA: Cancer of Prostate Risk Assessment; COG-TB: cognitive fusion targeted biopsy; CAPRA-S: CAPRA Post-Surgical scoring system; NCDB: National Cancer Database; PBC: positive biopsy core; SEER: Surveillance, Epidemiology, and End Results
