CURRENT VIEWS OF THE GLEASON GRADING SYSTEM

The authors provide the proceedings of the 2005 First International Society of Urological Pathology Consensus Conference and the basic provisions that differ the modified Gleason grading system from its original interpretation. In particular, we should do away with Gleason grade 1 (or 1 + 1 = 2) while assessing the needle biopsy specimens. Contrary to the recommendations by Gleason himself, the conference decided to apply stringent criteria for using Gleason grades 3 and 4. This is due to the fact that these grades are of special prognostic value so it is important to have clear criteria in defining each Gleason grade. Notions, such as secondary and tertiary Gleason patterns, are considered; detailed recommendations are given on the lesion extent sufficient to diagnose these components.