Prostate Cancer Grading, Time To Go Back To The Future

In November 2014, the International Society of Urological Pathology (ISUP) convened a consensus meeting in Chicago, USA to consider grading criteria for prostatic adenocarcinoma [1]. The primary purpose and main outcome of this meeting was a recommendation that not only should the Gleason score of prostate cancer be reported but that grading should also incorporate a 5-tier grade based on a grouping of Gleason scores. The outcome of the conference has resulted in widespread confusion as to the grading nomenclature. This has weighed heavily on the prostate cancer literature to the extent that the time has now come to question the scientific value of the score grouping.