Practice patterns related to prostate cancer grading: results of a 2019 Genitourinary Pathology Society clinician survey

Samson W. Fine*, Kiril Trpkov, Mahul B. Amin, Ferran Algaba, Manju Aron, Dilek E. Baydar, Antonio Lopez Beltran, Fadi Brimo, John C. Cheville, Maurizio Colecchia, Eva Comperat, Tony Costello, Isabela Werneck da Cunha, Warick Delprado, Angelo M. DeMarzo, Giovanna A. Giannico, Jennifer B. Gordetsky, Charles C. Guo, Donna E. Hansel, Michelle S. HirschJiaoti Huang, Peter A. Humphrey, Rafael E. Jimenez, Francesca Khani, Max X. Kong, Oleksandr N. Kryvenko, L. Priya Kunju, Priti Lal, Mathieu Latour, Tamara Lotan, Fiona Maclean, Cristina Magi-Galluzzi, Rohit Mehra, Santosh Menon, Hiroshi Miyamoto, Rodolfo Montironi, George J. Netto, Jane K. Nguyen, Adeboye O. Osunkoya, Anil Parwani, Christian P. Pavlovich, Brian D. Robinson, Mark A. Rubin, Rajal B. Shah, Jeffrey S. So, Hiroyuki Takahashi, Fabio Tavora, Maria S. Tretiakova, Lawrence True, Sara E. Wobker, Ximing J. Yang, Ming Zhou, Debra L. Zynger, Jonathan I. Epstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Purpose: To survey urologic clinicians regarding interpretation of and practice patterns in relation to emerging aspects of prostate cancer grading, including quantification of high-grade disease, cribriform/intraductal carcinoma, and impact of magnetic resonance imaging-targeted needle biopsy. Materials and methods: The Genitourinary Pathology Society distributed a survey to urology and urologic oncology-focused societies and hospital departments. Eight hundred and thirty four responses were collected and analyzed using descriptive statistics. Results: Eighty percent of survey participants use quantity of Gleason pattern 4 on needle biopsy for clinical decisions, less frequently with higher Grade Groups. Fifty percent interpret “tertiary” grade as a minor/<5% component. Seventy percent of respondents would prefer per core grading as well as a global/overall score per set of biopsies, but 70% would consider highest Gleason score in any single core as the grade for management. Seventy five percent utilize Grade Group terminology in patient discussions. For 45%, cribriform pattern would affect management, while for 70% the presence of intraductal carcinoma would preclude active surveillance. Conclusion: This survey of practice patterns in relationship to prostate cancer grading highlights similarities and differences between contemporary pathology reporting and its clinical application. As utilization of Gleason pattern 4 quantification, minor tertiary pattern, cribriform/intraductal carcinoma, and the incorporation of magnetic resonance imaging-based strategies evolve, these findings may serve as a basis for more nuanced communication and guide research efforts involving pathologists and clinicians.

Original languageEnglish (US)
Pages (from-to)295.e1-295.e8
JournalUrologic Oncology: Seminars and Original Investigations
Issue number5
StatePublished - May 2021


  • Active surveillance
  • Cribriform
  • Grading
  • MRI
  • Prostate cancer

ASJC Scopus subject areas

  • Urology
  • Oncology


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