Gleason Pattern 4 Burden and Adverse Pathology in ISUP Grade Group 2 Prostate Cancer: Implications for Active Surveillance Selection

Abstract

Simple Summary Selecting men with ISUP Grade Group (GG) 2 prostate cancer for active surveillance remains challenging. In this Flow, 10% (and up to 15% in selected cases) combined with low PSA density reliably identifies organ-confined, non-upgraded pathology. These quantitative thresholds provide objective criteria to refine surveillance eligibility and prevent overtreatment.