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Gleason score

Dr Yuranga Weerakkody and Dr Jeremy Jones et al.

The Gleason score determines the histological grading of prostate cancer. A score of 1 to 5 is assigned to each of the two largest areas of tumour involvement in the samples obtained, based on the worst feature.

1 = least aggressive.
5 = most aggressive.

These two scores are then added together to a Gleason score of 2 - 10. This final score can then be grouped variably into histopathologic grades which correlate with progression free survival, although exactly how these are grouped varies from publication to publication. For examples ¹:

2 - 4 (low grade)
- 100% progression free at 5 years
- 95.6% progression free at 10 years
5 - 6
- 96.9% progression free at 5 years
- 81.9% progression free at 10 years
7
- 76.9% progression free at 5 years
- 51.4% progression free at 10 years
8 - 9
- 59.1% progression free at 5 years
- 34.9% progression free at 10 years