PROGNOSTIC ROLE OF NEW CONTEMPORARY GRADING SYSTEM IN PROSTATE CANCER

Ezhil Arasi N., Zaheda Kausar and *Sandeep Kumar Lakkarasu

ABSTRACT

Gleason grade of prostatic carcinoma is an established prognostic indicator that has stood the test of time. The International Society of Urological Pathology first made revisions to the grading system in 2005, and subsequently in 2014. Additionally, a new grading system composed of Grade Groups 1 to 5 that was first developed in 2013 at the Johns Hopkins Hospital. This new grading system has been accepted by the World Health Organization (WHO). The aim of the present study was to categorize the cases of prostatic adenocarcinoma based on New contemporary grading system and to discuss it’s prognostic significance. A total of 124 cases were studied at Osmania General Hospital, Hyderabad prospectively over a period of 1 year, from May 2015 to April 2016. In the present study, out of 124 cases, 108 cases(87%) were BPH and 16 cases(13%) were adenocarcinoma. The present study used New contemporary grading system for categorization, majority of the cases were in grade group IV (7 cases, 43.75%) followed by group I (3 cases, 18.75%) and group II, group III, group V each comprising of 2 cases. The new grading system provides more accurate grade stratification than current applications of the Gleason system. It is simple, with 5 grade groups as opposed to 25 scores depending on various Gleason pattern combinations, the lowest grade in the new system is 1 as opposed to 6 in the Gleason system avoiding unnecessary treatment of indolent cancers.

Keywords: Adenocarcinoma, contemporary, Gleason, Grading, Prognostic, Prostate.