Contemporary International Society for Urological Pathology Grade Group System 2014: A 2-Year Retrospective Review of Prostate Cancers Diagnosed in Lagos University Teaching Hospital

Abstract

Abstract Introduction Prostate cancer is the second most frequent cancer worldwide. It is the commonest cancer among men in Nigeria. Gleason grading and scoring system constitute the most useful prognostic indicator in prostate cancer diagnosis and management. Over the years, it has gone through important modifications. The most recent of these changes was in 2014 by the International Society for Urological Pathology (ISUP). The WHO adopted the new grading system in 2016. It was not adopted as part of routine reporting of prostate cancer biopsies in Lagos University Teaching Hospital (LUTH) until 2017. The aim of this study is to categorize prostate cancers diagnosed in LUTH based on the grade group system and determine the pattern of prognostic distribution of prostate cancer cases since its adoption. Methods This is a descriptive study; data were retrieved from the histopathologic records of the Department of Anatomic Pathology. Prostate cancers cases diagnosed between 2017 and 2018 were stratified using the WHO-adopted 2014 ISUP grading system. Results During the 2 years, 93 cases of prostate cancers were diagnosed by core needle biopsies. Overall, mean age of cases was 69.85 years (SD 8.49, median = 70 years). Nearly 39% of the 93 cases were ISUP grade group 5 and about 24% were ISUP grade group 4. Together ISUP grade groups 3, 4, and 5 constituted 76.35% of all cases of prostate cancers. There was no statistically significant association between ISUP grade group and age (P = .266). Perineural invasion was present in 35.82% of cases. Sixty-seven percent of these were ISUP grade group 5. Conclusion The data from this study suggest that high-grade cancers, particularly those of the ISUP grade group 5, are the most frequently diagnosed prostate cancers in our institution. Further studies are required to document biochemical recurrence-free progression and survival among our patients.