The Impact of the 2005 International Society of Urological Pathology Consensus Conference on Standard Gleason Grading of Prostatic Carcinoma in Needle Biopsies

Billis, Athanase; Guimarães, Marbele Santos; Freitas, Leandro Luiz Lopes de; Meirelles, Luciana Rodrigues de; Magna, Luís Alberto; Ferreira, Ubirajara

doi:10.1016/j.juro.2008.04.018

Cited by 137 publications

(103 citation statements)

References 14 publications

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“…The International Society of Urological Pathology Consensus Conference modified the Gleason grading in 2005 (Shah et al, 2009) according to which Gleason grades were updated according to new criteria. Several studies have validated the prognostic value of these modifications (Billis et al, 2008;Dong et al, 2012). As shown in Table (5), Gleason score 7 was the commonest score in our series, followed by Gleason score 9.…”

Section: Discussionsupporting

confidence: 54%

Overview of Benign and Malignant Prostatic Disease in Pakistani Patients: A Clinical and Histopathological Perspective

Arshad

Ahmad²

2013

Asian Pacific Journal of Cancer Prevention

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Section: Discussionsupporting

confidence: 54%

Overview of Benign and Malignant Prostatic Disease in Pakistani Patients: A Clinical and Histopathological Perspective

Arshad

Ahmad²

2013

Asian Pacific Journal of Cancer Prevention

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“…After the re-evaluation, a higher number of patients was assigned to the prognostic group of GS 8-10, exhibiting, at follow-up, a shorter time to biochemical disease recurrence (log-rank P=0.011) (9).…”

Section: Introductionmentioning

confidence: 99%

Upgrading and upstaging in prostate cancer: From prostate biopsy to radical prostatectomy

D’Elia¹,

Cerruto²,

Cioffi³

et al. 2014

Molecular and Clinical Oncology

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Abstract. Prostate cancer (CaP) is the most common malignancy in men and the second cause of cancer-related mortality after lung cancer. Several studies have evaluated the correlation between bioptic and pathological Gleason score (GS), documenting a correlation ranging between 30 and 60%. The aim of this study was the evaluation of the association between bioptic and pathological GS in a series of patients undergoing prostate needle biopsy and subsequent radical prostatectomy. We also aimed to evaluate the possible prognostic factors of upgrading and upstaging. We prospectively collected and retrospectively reviewed data from 300 consecutive patients who underwent radical retropubic or robot-assisted prostatectomy at our Institution. Patients who underwent prostate needle biopsy, transrectal or transperineal, with a minimum of 5 samples, were included in this study. Upgrading and downgrading were defined as increase or decrease, respectively, from one prognostic grade group to another, similar to up-or downstaging. The mean age of the patients was 62.97 years and the mean prostate-spesific antigen (PSA) level was 7.83 ng/ml. A total of 51.3% of the population underwent a transperineal prostate biopsy. The most frequently represented bioptic GS was 3+3 (64.0%) followed by 3+4=7 (15.6%); the most frequent pathological Gleason score was 3+4 (44.3%), followed by 3+3 (31.0%). With reagard to the bioptic GS 4-5-6 group, approximately half of the specimens (46.7%) were subsequently upgraded to GS 3+4, and 5.3% to 4+3. With regards to the bioptic GS 3+4 group, 57.4% was confirmed in the surgical specimen. In the 4+3 group, 23.5% of the cases was downgraded to 3+4 and 35.3% was confirmed. With regards to stage, ~39.7% of the patients received an upstaging on the pathological specimen. We evaluated the correlations between preoperative serum PSA level, prostate volume, digital rectal examination and biopsy type and none of the variables considered exhibited a correlation with any upgrading (P>0.05). Moreover, we evaluated the correlations between the aforementioned variables and upstaging and, at the multivariate analysis, only a serum PSA <4 ng/ml was found to be an independent variable predictive of upstaging (P=0.017). Therefore, new tools are required to predict upgrading and upstaging of our patients, in order to ensure better counseling for optimal treatment planning.

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“…Helpap and Egevad 9 compared the grade distributions in needle biopsies for the 2 grading systems and found that the proportion of cancers with a score of 7 increased from 26% in the classic system to 68% in the ISUP 2005 modified Gleason scoring system; the proportion of cancers with a score of 6 decreased from 48% to 22%. In a similar investigation, Billis and colleagues 10 found that the proportion of cancers with a score of 7 increased from 26% in the classic system to 39% in the ISUP 2005 modified Gleason scoring system; the proportion of cancers with a score of 6 decreased from 68% to 39%. In another study, 11 the ISUP 2005 modified Gleason scoring system resulted in needle biopsy scores that were higher than the scores of the classic system by 16%.…”

Section: Commentmentioning

confidence: 86%

Comparison of Classic and International Society of Urological Pathology 2005 Modified Gleason Grading Using Needle Biopsies From the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) Trial

Lucia

Bostwick

Somerville

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Objective.-To compare scores derived using the 2 scoring systems.Design.-On-study and for-cause biopsies were centrally reviewed and assigned a classic Gleason score in the Reduction by Dutasteride of prostate Cancer Events trial. Positive biopsies were reviewed by an independent pathologist in a secondary review using the ISUP 2005 modified Gleason score. The independent pathologist also recorded a classic Gleason score.Results.-In total, 1482/1507 (98%) positive biopsy results were independently reviewed. Scores assigned by the 2 pathologists (classic versus modified) agreed in 83% (1230 of 1481) of cases; 99% (1471 of 1481) of cancers were within 61 of their previous score. Of discordant cases, similar numbers of biopsies were upgraded and downgraded in the secondary review, with minor differences in the score distributions. Interobserver agreement was good, with j values ranging from 0.62 (95% confidence interval [CI], 0.56-0.67) to 0.70 (95% CI, 0.65-0.76). The overall number of high-grade tumors (Gleason score 8-10; n ¼ 48) remained constant between reviews, with 3 fewer cases in the placebo group (n ¼ 16) and 3 more in the dutasteride group (n ¼ 32) in the secondary review. When comparing the independent pathologist's modified scores versus the classic, 17 of 1481 cancers (1.1%) were upgraded (including 9 of 17 upgrades [53%] to high-grade tumors).Conclusions.-This analysis showed similar score distributions between the classic and modified Gleason scoring systems. The differences seen between the 2 pathologists' scores likely reflect differences in interpretation rather than the scoring system chosen.

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The Impact of the 2005 International Society of Urological Pathology Consensus Conference on Standard Gleason Grading of Prostatic Carcinoma in Needle Biopsies

Abstract: The findings of this study indicate that the recommendations of the International Society of Urological Pathology are a valuable refinement of the standard Gleason grading system.

Cited by 137 publications

References 14 publications

Overview of Benign and Malignant Prostatic Disease in Pakistani Patients: A Clinical and Histopathological Perspective

Overview of Benign and Malignant Prostatic Disease in Pakistani Patients: A Clinical and Histopathological Perspective

Upgrading and upstaging in prostate cancer: From prostate biopsy to radical prostatectomy

Comparison of Classic and International Society of Urological Pathology 2005 Modified Gleason Grading Using Needle Biopsies From the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) Trial

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