How do you incorporate the recent proposed guidelines for using a prostate cancer "Grade Grouping" system (i.e. scores 1-5) into your clinical practice?

As theMedNet is a less formal venue for discourse I will do away with any pretense and answer the question honestly. I have no idea how I or anyone should incorporate this new system into practice. Although validated, the new system has not been used in randomized trials and one musn’t be overly dogmatic about its use. This is the same problem with the current risk groupings which have not been used to define eligibility for most randomized trials. I will say that our pathologists at Duke are using it routinely.

Let's start with the positives. First, I expect that the effort put forth by Dr. Epstein and large group that he assembled (I was not involved) will lead to more consistency in reporting; both on an individual patient level and for r...

@Dr. First Last should've been at the table. I prefer the 6 categories as well since it fits better into our clinical decision making alforithm. Never understood how they forgot about the importance of PSA and T3/4 disease

Best of luck trying to simplify all of this for your patients in time to get to the next one sitting in the waiting room. And don't forget to keep it simple.