title: Prognostic implications of 2005 Gleason grade modification. Population-based study of biochemical recurrence following radical prostatectomy.
abstract: OBJECTIVE
  To assess the impact of the 2005 modification of the Gleason classification on risk of biochemical recurrence (BCR) after radical prostatectomy (RP).
  
  
  METHODS
  In the Prostate Cancer data Base Sweden (PCBaSe), 2,574 men assessed with the original Gleason classification and 1,890 men assessed with the modified Gleason classification, diagnosed between 2003 and 2007, underwent primary RP. Histopathology was reported according to the Gleason Grading Groups (GGG): GGG1 = Gleason score (GS) 6, GGG2 = GS 7(3 + 4), GGG3 = GS 7(4 + 3), GGG4 = GS 8 and GGG5 = GS 9-10. Cumulative incidence and multivariable Cox proportional hazards regression models were used to assess difference in BCR.
  
  
  RESULTS
  The cumulative incidence of BCR was lower using the modified compared to the original classification: GGG2 (16% vs. 23%), GGG3 (21% vs. 35%) and GGG4 (18% vs. 34%), respectively. Risk of BCR was lower for modified versus original classification, GGG2 Hazard ratio (HR) 0.66, (95%CI 0.49-0.88), GGG3 HR 0.57 (95%CI 0.38-0.88) and GGG4 HR 0.53 (95%CI 0.29-0.94).
  
  
  CONCLUSIONS
  Due to grade migration following the 2005 Gleason modification, outcome after RP are more favourable. Consequently, outcomes from historical studies cannot directly be applied to a contemporary setting. J. Surg. Oncol. 2016;114:664-670. © 2016 Wiley Periodicals, Inc.
authors: Copenhagen Prostate Cancer Center and Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. thomsen.frederik@gmail.com.
authors: Frederik B
authors: FB
authors: Thomsen
authors: Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden.
authors: Yasin
authors: Y
authors: Folkvaljon
authors: Copenhagen Prostate Cancer Center and Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Klaus
authors: K
authors: Brasso
authors: Department of Urology, Population Health and the Laura and Isaac Perlmutter Cancer Institute, New York University and Manhattan Veterans Affairs Medical Center, New York, New York.
authors: Stacy
authors: S
authors: Loeb
authors: Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.|Department of Urology, Ryhov Hospital, Jönköping, Sweden.
authors: David
authors: D
authors: Robinson
authors: Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden.
authors: Lars
authors: L
authors: Egevad
authors: Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.|Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University Hospital, Umeå, Sweden.
authors: Pär
authors: P
authors: Stattin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery
chemical_list: D017430:Prostate-Specific Antigen
keywords: Gleason classification; ISUP; biochemical recurrence; prostate cancer; radical prostatectomy