Table III.

Unresolved Disagreements Between GUPS and ISUP Recommendations.

Issues		GUPS 2019 Recommendations	ISUP 2019 Recommendations
IDC-P admixed with invasive PCa		Only grade invasive PCa; do not assign Gleason score for IDC-P in any setting.	Assign Gleason score for the entire lesion, both invasive PCa and IDC-P.
Performing basal cell stains to differentiate IDC-P and invasive PCa		Necessary, but only in a minority of cases; only perform basal cell stains if the result would change the highest Grade Group for the case.	Unnecessary, because IDC-P is assigned Gleason score as if it were invasive PCa.
Minor/tertiary pattern in RP specimens	GP3 (≥5%), GP4, and GP5 present with GP5 < 5%	GS 3 + 4 = 7 or 4 + 3 = 7 with minor/tertiary pattern 5
	> 95% GP3 with < 5% GP4*	GS 3 + 4 = 7	GS 3 + 3 = 6
			with minor/tertiary pattern 4
	> 95% GP3 with < 5% GP5*	GS 3 + 5 = 8	GS 3 + 3 = 6
			with minor/tertiary pattern 5
	> 95% GP4 with < 5% GP5*	GS 4 + 5 = 9	GS 4 + 4 = 8
			with minor/tertiary pattern 5

*According to GUPS recommendation, minor/tertiary does not apply in these scenarios.

IDC-P, intraductal carcinoma of the prostate; PCa, prostatic adenocarcinoma; GS, Gleason score; GP, Gleason pattern; RP, radical prostatectomy.