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Gleason score 3+4=7 (prognostic grade group II) indicating the majority is pattern 3; Gleason score 4+3=7 (prognostic grade group III) where pattern 4 is dominant; [6] Gleason score 4+4=8 (prognostic grade group IV); Gleason scores 9-10 (prognostic grade group V). [7] Prostate cancers with a Gleason score ≤ 6 usually have rather good prognoses.
The favored treatment option depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors include the man's age, his general health, and his feelings about potential treatments and their possible side-effects.
A more refined prognosis can be established by consideration of prostate-specific antigen, and grade (i.e. Gleason score in the Gleason grading system). For example, it is common to classify patients into high, intermediate and low-risk groups on the basis of these three factors (TNM stage, PSA and Gleason score).
The histopathologic subdiagnosis of prostate cancer has implications for the possibility and methodology of any subsequent Gleason scoring. [1] The most common histopathological subdiagnosis of prostate cancer is acinar adenocarcinoma, constituting 93% of prostate cancers. [ 2 ]
Of the many cancer-specific schemes, the Gleason system, [3] named after Donald Floyd Gleason, used to grade the adenocarcinoma cells in prostate cancer is the most famous. This system uses a grading score ranging from 2 to 10. Lower Gleason scores describe well-differentiated less aggressive tumors.
Thus, any given patient could have a score of between two and ten——the higher the score, the more aggressive the cancer, and the lower the chance of survival. Gleason found the score directly related to survival rates in a study of 270 patients, which was the basis of his journal report.