A report of the workshops on the current status of the histologic grading of prostate cancer

Abstract

A national multidisciplinary study of four major systems for the histological grading of primary prostatic cancer was completed during 1978. In a series of workshops culminating in a final review, criteria of grading were critically assessed against the background of patient survival data. The overall consensus was that the Gleason system should tentatively be adopted as the pathologic reference point for classifying patients. This system can be used in conjunction with other systems. It seems definable, reproducible, reasonably simple, and has clinical relevance as judged by correlations with patient survival. Further study may demonstrate advantages from incorporation of the nuclear or cytologic characteristics of tumor cells into the Gleason system. Newer techniques of acid phosphatase determination, bone scans, and assessment of the regional lymph nodes should provide better staging criteria for correlation with primary tumor histology in the future. These workshops presented a unique opportunity for representative clinicians and pathologists in the United States to express their viewpoints in a comprehensive fashion on this timely and important topic.