A 67-year-old man has a PSA of 12 ng/mL and a systematic biopsy shows Gleason 7 (3+4) in 3 of 12 cores. MRI of the prostate shows a PI-RADS 4 lesion in the peripheral zone. He is offered active surveillance vs. treatment. The Gleason grade group corresponding to Gleason 3+4=7 is:
- A Grade Group 2 ✓
- B Grade Group 1
- C Grade Group 3
- D Grade Group 4
Correct answer: A. Grade Group 2
Explanation
The 2014 ISUP/Grade Group (GG) classification maps Gleason scores to groups: GG1 = Gleason ≤6; GG2 = Gleason 3+4=7; GG3 = Gleason 4+3=7; GG4 = Gleason 4+4 or 3+5 or 5+3=8; GG5 = Gleason 9–10. Gleason 3+4 is GG2, indicating favourable intermediate-risk disease. This distinction is important as GG2 may be considered for active surveillance in selected patients per current NCCN/EAU guidelines.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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