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Current practice of Gleason grading among genitourinary pathologists.
Lars Egevad1, William C Allsbrook, Jonathan I Epstein
1Department of Pathology and Cytology, Karolinska Hospital, Stockholm, Sweden. lars.egevad@onkpart.ki.se
Human Pathology
|February 16, 2005
Summary
Standardizing Gleason grading for prostate cancer is crucial. This study reveals significant variations in how pathologists interpret and report Gleason patterns on needle biopsies, highlighting a need for global consistency.
Area of Science:
- Uropathology
- Oncology
- Medical Diagnostics
Background:
- The Gleason system is the standard for prostate cancer grading.
- Controversies exist regarding the practical application of Gleason grading.
- Variations in Gleason grading can impact patient treatment and prognosis.
Purpose of the Study:
- To survey current practices in Gleason grading among genitourinary pathologists worldwide.
- To identify areas of inconsistency in the interpretation and reporting of Gleason patterns.
- To inform the development of standardized Gleason grading guidelines.
Main Methods:
- A global questionnaire survey was distributed to 91 genitourinary pathologists.
- Response rate was 74%, with participants from North America and other continents.
- The survey assessed the interpretation of Gleason patterns (GP) and Gleason scores (GS) on needle biopsies (NBX).
Main Results:
- Low rates of diagnosing low Gleason scores (GS 2-4) on NBX.
- Inconsistent classification of cribriform patterns (GP 3 and GP 4).
- Varied criteria for identifying GP 5 and reporting tertiary patterns.
- Diverse methods for reporting Gleason scores on NBX (global, highest, or per core).
Conclusions:
- There is a significant need to standardize the practical application of Gleason grading.
- Standardization is required for both the interpretation of Gleason patterns and the reporting of Gleason scores.
- Survey data provide insights into common grading practices among specialists.