Usefulness of the 2005 International Society of Urologic Pathology Gleason grading system in prostate biopsy and radical prostatectomy specimens
Article first published online: 8 DEC 2008
© 2008 THE AUTHORS. JOURNAL COMPILATION © 2008 BJU INTERNATIONAL
Volume 103, Issue 9, pages 1190–1194, May 2009
How to Cite
Uemura, H., Hoshino, K., Sasaki, T., Miyoshi, Y., Ishiguro, H., Inayama, Y. and Kubota, Y. (2009), Usefulness of the 2005 International Society of Urologic Pathology Gleason grading system in prostate biopsy and radical prostatectomy specimens. BJU International, 103: 1190–1194. doi: 10.1111/j.1464-410X.2008.08197.x
- Issue published online: 7 APR 2009
- Article first published online: 8 DEC 2008
- Accepted for publication 4 September 2008
- prostate cancer;
- ISUP Gleason score;
- needle biopsy;
- biochemical failure
To determine whether the 2005 International Society of Urologic Pathology (ISUP) Gleason Grading Consensus is clinically more useful than the conventional Gleason score (CGS), we compared the CGS and ISUP GS (IGS) of prostate needle biopsy (NB) and radical prostatectomy (RP) specimens, and evaluated the prognostic value of the ISUP GS.
PATIENTS AND METHODS
Of 250 patients undergoing RP, 103 with clinical stage T1–2 N0M0 were enrolled. Pathological tumour grades of NB and RP specimens were classified according to CGS by experienced pathologists in the central pathology department of our hospital, and retrospectively according to IGS by one uropathologist at the central pathology department of another hospital. All patients had RP with no neoadjuvant or adjuvant therapy. We analysed associations of CGS and IGS with biochemical recurrence-free survival (BRFS) after RP.
The concordance rates between NB and RP specimens by CGS and IGS were 64.1% and 69.9%. Under-grading and over-grading rates by CGS and IGS were 28.2% and 7.8% for NB, and 27.2% and 2.9% for RP, respectively. There was a significant difference in the over-grading rate between CGS and IGS (P = 0.026). When CGS and IGS of NB and RP specimens were compared, the concordance rates were similar, at 67% and 69.9%. The IGS was higher, by 15.6% in NB and by 20.4% in RP specimens, than CGS. Patients were divided into three groups based on IGS of NB specimens (≤6, 7 and ≥8). These groups differed significantly in BRFS after RP (P = 0.022); CGS showed no such association.
The IGS of NB specimens were significantly associated with BRFS after RP. The ISUP system is thus clinically useful for determining the most appropriate treatments for patients with early-stage prostate cancer.