ABSTRACT
Background: The Gleason score is the most widely accepted histopathological grading system for prostate cancer since decade despite having many deficiency that can potentially impact patient health care. So ISUP agreed on developing a system of prognostic grade groups from I-V. Aim and objective was to study the new perspectives of modified Gleason’s grading and to compare it with original Gleason’s System with focus on the prognostic significance of the modifications.Methods: A retrospective study of 60 patients, who underwent TURP and Sextant biopsy and diagnosed as prostatic carcinoma in our institute were included in this study. Laboratory requisition forms with clinical history, PSA levels and histopathology reports of these patients were reviewed and graded accordingly to the newer gleasons. New Gleason grade includes five distinct Grade Groups based on the modified Gleason score groups. Grade Group 1 = Gleason score ≤6, Grade Group 2 = Gleason score 3 + 4 = 7, Grade Group 3 = Gleason score 4 + 3 = 7, Grade Group 4 = Gleason score 8, Grade Group 5 = Gleason scores 9 and 10 were assigned. The change in the grading system is tabulated and compared separately.Results: Patients age ranged from 55-80 years. The number of cases were 3,12,15,19 and 11 categorized under grade group I, grade group II, grade group III, grade group IV, grade group V cancer respectively according to modified gleason grading.Conclusions: Modified Gleason is a simplified grading system which may reduce over treatment of indolent prostate cancer. New gleasons grading clarifies the clinicians about the dilemma of gleason scores, offering an excellent prognostic stratification of this carcinoma.