This Gleason score calculator for prostate cancer evaluates the stage and prognosis of prostate neoplasm based on biopsy tissue. Below the form you can find more information about the staging system used, the five grades and prognostic rates.
What is the Gleason score for prostate cancer calculator?
This is a health tool helping with the staging of prostate cancer based on biopsy findings. The Gleason grading system is a scale describing the aggressiveness of prostate cancer and refers to the microscopic examination of the sample tissue in the prostate biopsy.
It is a comparison of the pattern in the cancerous tissue with normal tissue in terms of shape, disposition and spread.
There are two grades assigned to the two predominant cancer cell patterns and first it is assessed the most commonly observed type of cell then the second most common type. This Gleason score for prostate cancer calculator uses the standard staging criteria in the model as follows.
The Gleason grades
This cancer score comprises of two components, a primary and a secondary one that are awarded a grade based on the cancerous tissue observed in the biopsy sample.
The primary grade describes the area with the most prominent cancer cells on a scale from 1 to 5.
The secondary grade observes the second most obvious area with cancer cells on a scale from 1 to 5, the more spread and the more different cancerous tissue is from the normal one, the higher the grade awarded.
1. Grade/Pattern 1 – Cancerous tissue cells resemble normal prostate cells. Glandular tissue is small and packed together. Indicating well differentiated carcinoma.
2. Grade/Pattern 2 – Some cells appear similar to normal prostate ones, others don’t. Glandular tissue is well formed but presents larger cells with more tissue between suggesting an increase in stroma. This indicates a moderately differentiated carcinoma.
3. Grade/Pattern 3 – Some cells resemble normal prostate ones, others don’t. The glandular tissue is still present with cells leaving it and invading the surrounding tissue. Some biopsy samples present an infiltrative pattern. This is still indicative for a moderately differentiated carcinoma. This is the most common observed pattern.
4. Grade/Pattern 4 – Some cells appear similar to normal prostate ones, others don’t and there is less recognizable glandular tissue as the cells are invading the surrounding tissue. This is indicative for a poorly differentiated carcinoma.
5. Grade/Pattern 5 – Cancerous tissue cells have an abnormal look, different from normal prostate cells and are appear scattered through the tissue. There are little prostate gland left as the cells have invaded the surrounding tissue thus creating an anaplastic carcinoma.
Gleason scores and prognostic
The primary grade plus the secondary grade equal the total Gleason score which ranges in theory between 2 and 10. However, at the moment in practice, pathologists use grades from 6 to 10 to describe cancers from biopsy tissue.
At the same time it is important to remember both the total score and its composition because a Gleason score of 7 is derived from either a 4+3 or a 3+4 and there is a major difference between the aggressiveness of each area in the two cases because a 4+3 is more aggressive as there is more grade 4 tissue.
The higher the total Gleason score, the more spread the cancer is and therefore the more aggressive and having a worse prognosis. A higher score indicates a cancer that is growing and is more likely to spread than a lower score one.
The most often met scores are 6 where cancer cells are well differentiated or 7 with moderately differentiated cells. A score of 6 indicates a slow growing cancer with good curing prospects. A score of 7 is indicative for an intermediate risk of cancer with a moderate aggressiveness while scores of 8, 9 or 10 are high grade neoplasm with poorly differentiated or undifferentiated cancer cells.
| Gleason score | Description |
| 6 (3+3) | All the cancer cells found in the sample are representative for grade 3 and exhibit a slow growth. |
| 7 (3+4) | The majority of cancer cells in the biopsy tissue exhibit a slow growth but there are also cells that have a moderate growth. |
| 7 (4+3) | The majority of cancer cells in the sample exhibit a moderate growth and are invading the surrounding tissue but there are also present cells appearing to grow slower. |
| 8 (4+4) | All the cancerous cells found in the sample are grade 4 with a moderate rate of growth and starting to invade the surrounding tissue. |
| 9 (4+5) | Most of the cancer cells in the sample appear to grow moderately fast while there are also present cells with a more rapid growth. |
| 9 (5+4) | The majority of cancer cells in the biopsy tissue appear scattered and invading surrounding tissue and grow at a more rapid rate than the other cells in the sample which have a more moderate growth rate. |
| 10 (5+5) | All the cancerous cells found in the sample exhibit a high rate of growth and there is less glandular tissue than normal. |
Based on the data in the Johns Hopkins Radical Prostatectomy Database (1982-2011) of Gleason grades and prognostics there have been reported the following rates:
Prognostic rates according to Gleason score
| Score | Grading |
| < 6 | I |
| 6 | I |
| 7 (3+4) | II |
| 7 (4+3) | III |
| 8 | IV |
| 9 | V |
| 10 | V |
References
1) Gleason, D. F. (1977). "The Veteran's Administration Cooperative Urologic Research Group: histologic grading and clinical staging of prostatic carcinoma". In Tannenbaum, M. Urologic Pathology: The Prostate. Philadelphia: Lea and Febiger. pp. 171–198. ISBN 0-8121-0546-X.
2) Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL; ISUP Grading Committee. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason grading of prostatic carcinoma. Am J Surg Pathol 2005;29(9):1228-42.
21 Jun, 2015