Question: 20170036

Status


Final

Category


#1:   Grade
#2:   Prostate
#3:  


References


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Notes:  
Source 2:  
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Question


Grade--Prostate: How are the prostate-related fields completed when documentation in pathology reports only includes one of the new grade groups? See Discussion.



Discussion


Our pathologists have starting to use a new prostate cancer grading system that was adopted by WHO in 2016. The new grading scheme correlates with the prior Gleason grading scheme as follows:

Grade Group 1 = Gleason score 6 or less
Grade Group 2 = Gleason score 3+4=7
Grade Group 3 = Gleason score 4+3 = 7
Grade Group 4 = Gleason score 8
Grade Group 5 = Gleason score 9-10

Our pathologists are no longer dictating the Gleason Primary and Secondary Pattern values nor the Gleason's Score. Reverse correlation from the new grade groups to the required patterns and score are difficult with Grade Groups 2 and 3 needing to be distinguished from one another and Grade Group 5 including two unique scores.

The prostate-related fields include:
Collaborative Site Specific Factor 7: Gleason's Primary Pattern and Secondary Pattern Values on Needle Core Biopsy/TURP
Collaborative Site Specific Factor 8: Gleason's Score On Needle Core Biopsy/TURP
Collaborative Site Specific Factor 9: Gleason's Primary Pattern and Secondary Pattern Values on Prostatectomy/Autopsy
Collaborative Site Specific Factor 10: Gleason's Score on Prostatectomy/Autopsy



Answer


When all you have is the grade group, you may use the following table to convert the Prostate Grade Groups to the appropriate code for the indicated fields.

Grade Group      Gleason Score     Gleason Pattern    SSF7   SSF8   SSF9  SSF10   Grade/diff

Grade Group 1     6 or less               <=3+3                        099      999     099     999        1

Grade Group 2     7                           3+4                            034      007     034     007        2

Grade Group 3     7                           4+3                            043      007     043     007        2

Grade Group 4     8                           4+4, 3+5, 5+3            999     999     999     999        3

Grade Group 5     9-10                      4+5, 5+4, 5+5            099     999     099     999        3  



History


When all you have is the grade group, you may use the following table to convert the Prostate Grade Groups to the appropriate code for the indicated fields. Grade Group Gleason Score Gleason Pattern SSF7 SSF8 SSF9 SSF10 Grade/diff Grade Group 1 6 or less <=3+3 099 999 099 999 1 Grade Group 2 7 3+4 034 007 034 007 2 Grade Group 3 7 4+3 043 007 043 007 2 Grade Group 4 8 4+4 044 008 044 008 3 Grade Group 5 9-10 4+5, 5+4, 5+5 099 999 099 999 3  

Last Updated


08/10/2017

Date Finalized


06/14/2017