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Prostate Cancer Grading: A Decade After the 2005 Modified Gleason Grading System
Oleksandr N Kryvenko1, Jonathan I Epstein
1From the Department of Pathology and Laboratory Medicine, Department of Urology, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (Dr Kryvenko); and the Departments of Pathology, Urology, and Oncology, The Johns Hopkins Medical Institutions, Baltimore, Maryland (Dr Epstein).
The Gleason grading system for prostate cancer has evolved since 1966. A new Grade Group system (1-5) has been developed and validated to improve prostate cancer grading accuracy.
Area of Science:
- Uropathology
- Oncologic Histology
Background:
- The original Gleason grading system, established in 1966, has limitations due to evolving diagnostic practices and the identification of new prostate cancer variants.
- Patterns 1 and 2 are rarely diagnosed, and the original system did not account for reporting multiple biopsy cores or separate tumor nodules on radical prostatectomy.
Purpose of the Study:
- To describe updates to prostate cancer grading.
- To introduce and discuss the new Grade Group grading system (1-5).
Main Methods:
- Review of historical changes in prostate cancer grading practices.
- Description of the development and validation of the new Grade Group system.
Main Results:
- The Gleason system has undergone revisions by the International Society of Urological Pathology in 2005 and 2014.
- A new Grade Group system (1-5) was developed at Johns Hopkins and validated in multi-institutional studies.
Conclusions:
- The new Grade Group system offers an updated approach to prostate cancer grading.
- This system has been accepted by pathologists and clinicians, aiming to enhance diagnostic consistency and patient management.
