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The study, based on 1875 patients, showed poor agreement between local and central pathology-derived Gleason Grade Group (GGG but good agreement in overall and worst GGG on central pathology. Stratification based on central pathology GGG performed better for patient outcomes, with GGG3 behaving like GGG4 for biochemical/clinical failure and distant metastases. Patients upgraded from GGG2-3 using worst biopsy GS showed similar outcomes to GGG3.
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