Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Reply to: Fact, overdiagnosis cannot be evaluated by comparing histological grading of prostate biopsy to prostatectomy specimen

Prostate Cancer and Prostatic Diseases volume 26, pages 802–803 (2023)Cite this article

Subjects

The Original Article was published on 09 December 2022

We read with great interest the comment by Stroomberg et al. on our study [1, 2]. We agree with the authors that overdiagnosis, relative to a non-screened population cannot be evaluated with our data and definitely we did not allude to that with our findings. In relatively recent times, authors have argued about a theoretical potential overdiagnosis of ISUP2 after the introduction of targeted biopsy and that many of those patients would have likely been diagnosed with ISUP1 on systematic biopsy, hence surveilled. What we aimed to demonstrate is the fact that almost all ISUP2 that are contemporarily diagnosed by means of targeted biopsy are not subject to downgrading; hence, radical treatment is justified, as per current guidelines [3, 4]. In addition, the “relatively” excess of ISUP2 compared to ISUP1 in contemporary series can indeed partly be ascribed to targeted biopsy but mostly to the MRI pathway that results in lower rates of diagnosis of clinically insignificant prostate cancer.

We would like to specify that in Table 1, we reported the variable pT stage as coded in the database as follows: 0 = pT2, 1 = pT3a, 2 = pT3b and 3 = pT4; this will be clarified in the table legend. In addition, we confirm that 210 men were not biopsy naive, yet, this factor was not associated with downgrading.

Table 1 Descriptive characteristics of the patient population.
Full size table

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Stroomberg HV, Brasso K, Røder A. Fact, overdiagnosis cannot be evaluated by comparing histological grading of prostate biopsy to prostatectomy specimen. Prostate Cancer Prostatic Dis. https://www.nature.com/articles/s41391-022-00629-z.

  2. Martini A, Touzani A, Mazzone E, Roumiguié M, Marra G, Valerio M, et al. Overdiagnosis and stage migration of ISUP 2 disease due to mpMRI-targeted biopsy: facts or fictions. Prostate Cancer Prostatic Dis. 2022;25:794–6.

    Article  CAS  PubMed  Google Scholar 

  3. NCCN Guidelines Prostate Cancer Version 1. https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. 2022.

  4. EAU Prostate Cancer Guidelines. https://uroweb.org/guidelines/prostate-cancer. 2022.

Download references

Author information

Authors and Affiliations

  1. La Croix du Sud Hospital, Quint Fonsegrives, France

    Alberto Martini & Guillaume Ploussard

  2. Institut Universitaire du Cancer-Toulouse, Oncopole, Toulouse, France

    Alberto Martini & Guillaume Ploussard

Authors
  1. Alberto Martini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guillaume Ploussard
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AM and GP: manuscript writing/editing.

Corresponding author

Correspondence to Guillaume Ploussard.

Ethics declarations

Competing interests

AM and GP own equities of Oltre Medical Consulting, Toulouse, France.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Martini, A., Ploussard, G. Reply to: Fact, overdiagnosis cannot be evaluated by comparing histological grading of prostate biopsy to prostatectomy specimen. Prostate Cancer Prostatic Dis 26, 802–803 (2023). https://doi.org/10.1038/s41391-022-00639-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41391-022-00639-x

Search

Advanced search

Quick links