What is grade grouping system for prostate cancer?

Updated: Jan 14, 2019
  • Author: Lanna Cheuck, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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The grade grouping system was introduced in 2013, and has been adopted by the NCCN. Like the Gleason score, the Grade Group is derived from needle-core biopsies in patients with suspected prostate cancer or analysis of a radical-prostatectomy specimen. However, in contrast with the three risk tiers defined by the Gleason score, the Grade Group distinguishes five risk groups based on the core with the worst grade, as follows:

  • Grade Group 1 - Gleason 3+3
  • Grade Group 2 - Gleason 3+4
  • Grade Group 3 - Gleason 4+3
  • Grade Group 4 - Gleason 8
  • Grade Group 5 - GS 9-10

In a study of 8052 patients, grade grouping at biopsy and radical prostatectomy demonstrated better discrimination of recurrence-free survival between individual risk groups than Gleason score risk groups, with Grade Groups 2, 3, 4, and 5 each incrementally associated with increased risk.​ [20]

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