Clinical validation of the 2005 isup gleason grading system in a cohort of intermediate and high risk men undergoing radical prostatectomy

Sheila F. Faraj, Stephania M. Bezerra, Kasra Yousefi, Helen Fedor, Stephanie Glavaris, Misop Han, Alan Wayne Partin, Elizabeth Humphreys, Jeffrey Tosoian, Michael Johnson, Elai Davicioni, Bruce Trock, Edward M. Schaeffer, Ashley E. Ross, George J. Netto

Research output: Contribution to journalArticle

Abstract

In 2005, the International Society of Urological Pathology (ISUP) introduced several modifications to the original Gleason system that were intended to enhance the prognostic power of Gleason score (GS). The objective of this study was to clinically validate the 2005 ISUP Gleason grading system for its ability to detect metastasis. We queried our institutional RP database for men with NCCN clinically localized intermediate to high-risk disease undergoing radical prostatectomy (RP) between 1992 and 2010 with no additional treatment until the time of metastatic progression. A case-cohort design was utilized. A total of 333 available RP samples were re-reviewed and GS was reassigned per the 2005 ISUP Gleason system. Cumulative incidence of metastasis was 0%, 8.4%, 24.5% and 44.4%among specimens that were downgraded, unchanged, had one point GS increase and two point GS increase, respectively. The hazard ratio for metastasis raised in GS 8 and 9 compared to GS 7 from 2.77 and 5.91 to 3.49 and 9.31, respectively. The survival c-index of GS increased from 0.70 to 0.80 when samples were re-graded at 5 years post RP. The c-index of the reassigned GS was higher than the original GS (0.77 vs 0.64) for predicting PCSM at 10 years post RP. The regraded GS improved the prediction of metastasis and PCSM. This validates the updated Gleason grading system using an unambiguous clinical endpoint and highlights the need for reassignment of Gleason grading according to 2005 ISUP system when considering comparisons of novel biomarkers to clinicopathological variables in archival cohorts.

Original languageEnglish (US)
Article numbere0146189
JournalPLoS One
Volume11
Issue number1
DOIs
StatePublished - Jan 5 2016

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Neoplasm Grading
Pathology
Prostatectomy
metastasis
Biomarkers
Neoplasm Metastasis
Hazards
endpoints
biomarkers
incidence
sampling
prediction

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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Clinical validation of the 2005 isup gleason grading system in a cohort of intermediate and high risk men undergoing radical prostatectomy. / Faraj, Sheila F.; Bezerra, Stephania M.; Yousefi, Kasra; Fedor, Helen; Glavaris, Stephanie; Han, Misop; Partin, Alan Wayne; Humphreys, Elizabeth; Tosoian, Jeffrey; Johnson, Michael; Davicioni, Elai; Trock, Bruce; Schaeffer, Edward M.; Ross, Ashley E.; Netto, George J.

In: PLoS One, Vol. 11, No. 1, e0146189, 05.01.2016.

Research output: Contribution to journalArticle

Faraj, SF, Bezerra, SM, Yousefi, K, Fedor, H, Glavaris, S, Han, M, Partin, AW, Humphreys, E, Tosoian, J, Johnson, M, Davicioni, E, Trock, B, Schaeffer, EM, Ross, AE & Netto, GJ 2016, 'Clinical validation of the 2005 isup gleason grading system in a cohort of intermediate and high risk men undergoing radical prostatectomy', PLoS One, vol. 11, no. 1, e0146189. https://doi.org/10.1371/journal.pone.0146189
Faraj, Sheila F. ; Bezerra, Stephania M. ; Yousefi, Kasra ; Fedor, Helen ; Glavaris, Stephanie ; Han, Misop ; Partin, Alan Wayne ; Humphreys, Elizabeth ; Tosoian, Jeffrey ; Johnson, Michael ; Davicioni, Elai ; Trock, Bruce ; Schaeffer, Edward M. ; Ross, Ashley E. ; Netto, George J. / Clinical validation of the 2005 isup gleason grading system in a cohort of intermediate and high risk men undergoing radical prostatectomy. In: PLoS One. 2016 ; Vol. 11, No. 1.
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AU - Fedor, Helen

AU - Glavaris, Stephanie

AU - Han, Misop

AU - Partin, Alan Wayne

AU - Humphreys, Elizabeth

AU - Tosoian, Jeffrey

AU - Johnson, Michael

AU - Davicioni, Elai

AU - Trock, Bruce

AU - Schaeffer, Edward M.

AU - Ross, Ashley E.

AU - Netto, George J.

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