Gleason Score / Grade Group

Epstein JI, Egevad L, Amin MB, et al. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: definition of grading patterns and proposal for a new grading system. Defined the five Grade Groups derived from the Gleason score.

Epstein JI, Zelefsky MJ, Sjoberg DD, et al. A contemporary prostate cancer grading system: a validated alternative to the Gleason score. In > 20 000 men the Grade Groups showed a monotonic, well-separated relationship with biochemical recurrence after prostatectomy or radiotherapy.

Grade Group is now reported alongside the Gleason score in the AJCC 8th edition and NCCN/EAU risk stratification. On needle biopsy the highest-grade core is generally used; a small amount of high-grade pattern (tertiary pattern 5) is reported separately and can raise the effective risk. Grading is a pathologist's assessment of the specimen — this tool only maps the reported patterns to the score and group.