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ISSN 2305-7939 (Electronic)

2017, Number 1

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RCU 2017; 6 (1)

A new prostate cancer classification based on prognostic grade groups

Farré X

Language: Spanish
References: 35
Page: 28-42
PDF size: 427.34 Kb.


ABSTRACT

Introduction: In 2013, Dr. Jonathan I. Epstein of the Johns Hopkins University (JHU) proposed a new prognostic classification of prostate cancer based on biochemical recurrence, which would more accurately reflect the biological aggressiveness of the tumor and fit current clinical recommendations.
Objective: To analyze the new prognostic classification of prostate cancer, in which Gleason scores from 6 to 10 are replaced by a new scale (Grade Groups (GG)) whose values range from 1 to 5, with grade 1 being the most favorable and grade 5 being the most unfavorable.
Methods: The review is based on (a) the original JHU study with the classification proposal, (b) the official publication of the International Society of Urological Pathology (ISUP) with the description of the new classification, (c) an extensive letter to the editor with additional comments on the ISUP conference, (d) another letter to the editor on the nomenclature of the new classification, and (e) a review of the literature to seek validation studies of the proposal of the classification.
Data analysis and integration: The review explains the origin of the new classification, as well as the features of each of the 5 prognostic grade groups. It compares each grade to the original Gleason system and describes its differences. It discusses some controversial issues, such as the indolence of the Gleason score 6, the percentage of pattern 4, and how to communicate the Gleason tertiary patterns with the new classification. Finally, it reports a few validation studies of the new classification and describes the relation of the new classification with some molecular characteristics of the tumors.
Conclusions: The new classification of Grade Groups will help pathologists improve the classification of prostate cancer based on glandular morphology. It will also be useful for other clinicians, researchers and patients, as it presents a better correlation with the current management of the disease.


REFERENCES

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