The evolving Gleason grading system

The Gleason grading system for prostate adenocarcinoma has evolved from its original scheme established in the 1960s-1970s, to a significantly modified system after two major consensus meetings conducted by the International Society of Urologic Pathology (ISUP) in 2005 and 2014, respectively.

The Gleason grading system has been incorporated into the WHO classification of prostate cancer, the AJCC/UICC staging system, and the NCCN guidelines as one of the key factors in treatment decision. Both pathologists and clinicians need to fully understand the principles and practice of this grading system. We here briefly review the historical aspects of the original scheme and the recent developments of Gleason grading system, focusing on major changes over the years that resulted in the modern Gleason grading system, which has led to a new "Grade Group" system proposed by the 2014 ISUP consensus, and adopted by the 2016 WHO classification of tumours of the prostate.

Chinese journal of cancer research = Chung-kuo yen cheng yen chiu. 2016 Feb [Epub]

Ni Chen, Qiao Zhou

Pathology Department, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China., Pathology Department, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China.

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