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However, problematic aspects of the original Gleason grading system still characterize the 2005 revision. The predominant lowest score assigned is Gleason 3+3 = 6. Patients who are told their Gleason score is 6 out of 10 may interpret that they have a more aggressive intermediate cancer and experience greater anxiety. [11]
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.
Although the role of surgery in these patients remains uncertain, those with high-risk disease are usually treated with radiotherapy and a long duration of hormonal ablation. Many high-risk patients are not cured by this treatment, and the search for better treatments in this group is a particularly pressing concern in prostate cancer research.
The lowest possible Gleason score of 6 represents a biopsy most similar to healthy prostate; the highest Gleason score of 10 represents the most severely cancerous. [note 1] Gleason scores are commonly grouped into "Gleason grade groups", which predict disease prognosis: a Gleason score of 6 is Gleason grade group 1 (best prognosis). A score of ...
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.
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