Validation of the WHO 2016 new Gleason score of prostatic carcinoma

Abstract

Context:New Gleason Score of Prostate.Aims:The aim of this study is to assign the patients with carcinoma prostate into new prognostic grade groups (PGGs) based on revised Gleason score (GS) and follow-up according to the WHO 2016.Subjects and Methods:All the biopsies/resected specimens of carcinoma prostate from January 2014 to June 2016 were reviewed, and GS was done according to the WHO 2016. Accordingly, cribriform, fused, and glomeruloid glands were assigned GS 4. Thus, two groups were identified with GS 7 (3 + 4 and 4 + 3). The patients were grouped into PGGs 1–5. The number of patients with change in the prognostic group along with follow-up was calculated.Results:There were 143 patients with carcinoma prostate, with a median age of 65 years. The initial GS was revised, and there was a decrease in GS 3 + 4 from 13.9% to 9% and increase in 4 + 3 from 19.6% to 23.8%. There was upgradation of PGG in 11 (7.69%) biopsies; with PGG from 1 to 2 in one; 2to 3 in eight; and 3to 4 in two. Follow-up at 2 years in 22 showed the poor prognoses in the patients who were upgraded to the higher prognostic group.Conclusions:A change in PGG according to the WHO 2016 criteria was assigned in 7.69% biopsies of carcinoma prostate, and it correlated with prognosis.

Understanding the gleason grading system and its changes

“…1 Gleason Grading System (GGS) is the most widely used system for prostatic adenocarcinoma. [1][2][3][4][5] It is one of the most useful predictors of prognosis of prostatic carcinoma. [2][3][4] The original GGS was used to grade acinar adenocarcinomas based on architectural features and it has an excellent correlation with clinical outcomes.…”

“…[1][2][3][4][5] It is one of the most useful predictors of prognosis of prostatic carcinoma. [2][3][4] The original GGS was used to grade acinar adenocarcinomas based on architectural features and it has an excellent correlation with clinical outcomes. 1,3 The grading system uses a 5 point scale where 1corresponds to well differentiated tumor and 5, the poorly differentiated.…”

“…6,7 The International Society of Urological Pathology (ISUP) introduced major modifications to the Gleason system in 2005. 2,4 There were a few modifications in the year 2010 ISUP on GGS2 followed by some controversies in 2014. 4 The GGS closely correlates with clinical behaviour and provides an important index of prognosis.…”

“…2,4 There were a few modifications in the year 2010 ISUP on GGS2 followed by some controversies in 2014. 4 The GGS closely correlates with clinical behaviour and provides an important index of prognosis. 8 The Gleason score is one of the key determinants in treatment decision making, together with stage, age, and prostate-specific antigen.…”

“…8 The Gleason score is one of the key determinants in treatment decision making, together with stage, age, and prostate-specific antigen. 1,4,7,8…”