title: Implications of the International Society of Urological Pathology modified Gleason grading system.
abstract: BACKGROUND
  Histologic grading is the clinically most useful tissue-based predictor of prognosis for prostate cancer. Over the years, there has been a gradual shift in how the Gleason grading is applied in practice, with a general trend toward upgrading. A consensus conference was organized in 2005 by the International Society of Urological Pathology (ISUP) for standardizing both the perception of histologic patterns and how the grade information is compiled and reported.
  
  
  OBJECTIVE
  To review the implications of the ISUP modified Gleason grading system.
  
  
  METHODS
  Personal experience and review of the current literature.
  
  
  CONCLUSIONS
  The recommendations regarding pattern interpretation and reporting are summarized. The practical consequences of the ISUP modification of the Gleason grading are reported. The prognostic importance of the Gleason score, its reproducibility, and its preoperative assessment are discussed. Subsequent proposals for slight modifications to the ISUP grading system are described.
authors.affiliation: Department of Pathology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Egevad
authors.forename: Roberta
authors.initials: R
authors.lastname: Mazzucchelli
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Montironi
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000473:pathology* / Q000628:therapy; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D017410:Practice Guidelines as Topic / Q000592:standards*; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000145:classification / Q000473:pathology* / Q000628:therapy; D015203:Reproducibility of Results; D012955:Societies, Medical; D016896:Treatment Outcome; D014572:Urology / Q000592:standards*