IntroductionGleason score (GS) at diagnostic biopsy is an important parameter for therapeutic decision‐making in men with prostate cancer. According to the International Society of Urologic Pathology (ISUP) and World Health Organisation (WHO) guidelines, pathologists should grade each biopsy containing cancer separately, provided that individual cores can be identified, and may also give an overall score for the entire case. However, prostate cancer heterogeneity and multifocality might result in variability of individual biopsy core GS. In such cases it is not evident which GS should be recorded for patient stratification and treatment. For instance, a patient might have one biopsy core presenting with 6 mm GS 3 + 3 = 6 and another biopsy core with 2 mm GS 4 + 3 = 7. In this case, stratification might be based either on the overall GS 3 + 4 = 7 or highest GS 4 + 3 = 7. Discordancy between overall and highest GS particularly affects men with GS 7, as optimal individual therapeutic strategies are not well defined in this subgroup. Studies on overall and highest GS show conflicting results, and have not focused on GS 3 + 4 = 7 in particular. We aimed to compare the clinicopathological characteristics and outcome of men with overall biopsy GS 3 + 4 = 7 with highest GS 3 + 4 = 7 (HI = OV) to those with highest GS > 3 + 4 = 7 (HI > OV).MethodsPatient
Histopathology – Wiley
Published: Jan 1, 2018
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