Publication: Modified gleason grading. An updated review
Authors
Helpap, Burkhard ; Egevad, Lars
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
At an ISUP (International Society of
Urological Pathology) consensus conference in 2005 in
San Antonio, Texas, the old Gleason grading system for
prostatic carcinoma from 1966 underwent its first major
revision. With this modified Grading system a shift of
the most frequent Gleason scores from 6 to 7a (3+4) in
biopsy specimens and an increased degree of agreement
between specimens of biopsies and radical
prostatectomies with carcinoma of the prostate could be
demonstrated. After modified grading of GS 3+4=7a
tumours 95% were stage pT2, while 79% of GS 4+3=7b
tumours were stage pT3-4. In cases with PSA <10ng/ml
and tumour extent <20% the most frequent Gleason
scores were 6 and 7a. Cases with serum PSA >10ng/ml
or tumour extent >20% had higher scores (7b or higher).
Cancers with tumour infiltration of <1mm in one of 12
cores and PSA <10ng/ml were mainly low grade
(Gleason scores 6 and 7a) and may correspond to so
called insignificant carcinoma of the prostate.
Conclusion: With the modified Gleason At an ISUP (International Society of
Urological Pathology) consensus conference in 2005 in
San Antonio, Texas, the old Gleason grading system for
prostatic carcinoma from 1966 underwent its first major
revision. With this modified Grading system a shift of
the most frequent Gleason scores from 6 to 7a (3+4) in
biopsy specimens and an increased degree of agreement
between specimens of biopsies and radical
prostatectomies with carcinoma of the prostate could be
demonstrated. After modified grading of GS 3+4=7a
tumours 95% were stage pT2, while 79% of GS 4+3=7b
tumours were stage pT3-4. In cases with PSA <10ng/ml
and tumour extent <20% the most frequent Gleason
scores were 6 and 7a. Cases with serum PSA >10ng/ml
or tumour extent >20% had higher scores (7b or higher).
Cancers with tumour infiltration of <1mm in one of 12
cores and PSA <10ng/ml were mainly low grade
(Gleason scores 6 and 7a) and may correspond to so
called insignificant carcinoma of the prostate.
Conclusion: With the modified Gleason system,
grade, stage, tumour extent and serum PSA show good
correlations and characterize the difference between low
and high grade malignancy of prostate carcinoma.
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