Comparison of Gleason Scoring-2005 and 2014 Updates

Gleason grading system has undergone remarkable changes since its inception in 1966 by Sir Donald Gleeson. It is used for prognostication of prostate cancer which is the second most common cancer among men worldwide. The aim of our study was to compare the changes between updates in Gleason scoring in 2005 and 2014. Eighty-eight prostate biopsy specimens reported earlier using 2005 Gleason scoring update were reviewed as per the 2014 guidelines. The changes in final scoring and the grade groups were recorded. Among 88 cases, 67 cases had the same total score. Of these cases around 58 had the same individual pattern scoring as per both 2005 and 2014 guidelines. However, 9 cases had same score but a change in individual score pattern. The remaining 21 cases demonstrated a change in total score. Nine cases were upgraded and had a higher final score, whereas 12 cases got downgraded and were shifted to a lower total score. Use of 2014 update has resulted in better reproducibility and reduced interobserver variability. It is simpler and is a better predictor of prognosis.