Identifying Men Who Can Remain on Active Surveillance Despite Biopsy Reclassification to Grade Group 2 Prostate Cancer.

Most GG1 men who enter AS and subsequently reclassify to GG2 have favorable findings at RP and can remain on AS. Among patients reclassified to GG2, those with low PSAD and without PNI had the lowest risk of RP adverse pathology, comparable to (or below) that of GG1 patients who were not reclassified to GG2 pre-operatively. PSAD and PNI stratify risk in AS patients reclassified to GG2 and if concordant with other clinicopathologic and radiographic findings, can enable more patients to remain on AS. Reclassification to GG2 alone should not disqualify men from remaining on AS.