Abstract
Background: Gleason score is one of the strongest prognostic predictors of prostate cancer;however, a change was published
which is a 5 step grouping system of prostatic adenocarcinomas according to their Gleason scores. The aim of this study is to
determine the relationship between histopathological findings and prognosis of tumors subgrouped according to the new Gleason
grade grouping system.
Methods: A total of 163 radical prostatectomies subgrouped into 5 prognostic groups were investigated for prognostic features
such as pathological stage, extraprostatic extension, surgical margin status, involvement of seminal vesicles, perineural invasion,
necrosis, vascular invasion, ganglionic involvement, concomitant high grade prostatic intraepithelial neoplasia (HPIN) in addition
to other microscopic features of tumors such as the presence of mucin and foamy cytoplasmic change between groups.
Results: The mean age of patients was 65.72 ± 6.67 (min = 46, max = 82). Among 131 patients who completed the study, the mean
prostate specific antigen (PSA) value was 11.29 ± 10.88. The statistically significant factors were significantly related to both the
original Gleason and the prognostic grade groups.The recurrence rate of grade group 4 patients (57%) was significantly higher
than grade group 3 patients (8%) (P = 0.038). But no significant difference was found between grade group 4 and 5 (P = 0.25).
Conclusion: Grade grouping systems reflect prognostic differences but adapting this new system into routine evaluation of patients
may confuse the clinicians; however, pathology reports stating both the traditional Gleason score and the new prognostic group
may soften the transition.