Cumulative incidence of metastasis at 5 years post radical prostatectomy.

<p>A) Difference in re-graded 2005 ISUP modified and original Gleason score; B) Difference in primary re-graded 2005 ISUP modified and original Gleason score; and C) Difference in secondary re-graded 2005 ISUP modified and original Gleason score.</p

(A) Fused glands (400x). In the original Gleason grading this pattern was considered pattern 3. According to the 2005 ISUP Gleason system it would be graded as pattern 4; B) Adenocarcinoma with glomeruloid features currently assigned a Gleason pattern 4 (100x); C) Ill-defined glands (100x). This pattern would be graded as Gleason pattern 4 by the ISUP 2005 Gleason grading; and D) Individual cells (100x).

<p>This pattern was originally accepted under Gleason pattern 3 and would be assigned a Gleason pattern 5 according to the 2005 ISUP Gleason system.</p

Study diagram and patient selection criteria.

<p>Study diagram and patient selection criteria.</p

A) Survival concordance index. Reviewed Gleason score by the 2005 ISUP modified Gleason system has the highest c-index compared to original Gleason score. B) Decision curve analysis at 5 years post radical prostatectomy shows the net benefit of original and reviewed Gleason score across probability thresholds.

<p>The reviewed Gleason score shows the highest net benefit.</p

Cumulative incidence curves of A) metastasis by original Gleason score, B) metastasis by reviewed Gleason score.

<p>The number at risk in each group is shown in the footnote lines. Patients in the sub-cohort who do not experience the event are weighted by the inverse of the sampling fraction in following the case-cohort design.</p