What is the Gleason Grading System for prostate cancer?

Updated: Mar 23, 2020
  • Author: Natasza M Posielski, MD; Chief Editor: E Jason Abel, MD  more...
  • Print
Answer

Answer

An additional factor influencing prognosis is histopathologic grading. Tissue obtained from a needle biopsy or a prostatectomy is graded using the Gleason Grading System. Gleason grades range from 1 to 5. Each specimen is assigned two grades based on the most common and second most common pattern. These numerical values are added to calculate the Gleason Score.

  Table 2. Gleason Score (Open Table in a new window)

Histopathologic grade (G)

GX

Gleason score cannot be assessed

Gleason ≤6

Well differentiated (slight anaplasia)

Gleason 7

Moderately differentiated (moderate anaplasia)

Gleason 8-10

Poorly differentiated or undifferentiated (marked anaplasia)

The 8th edition of the AJCC Cancer Staging Manual took effect on January 1, 2018. A major change is that tumor grading now involves the Gleason Score, as well as the grade group. [3]

Table 3. Grade Group (Open Table in a new window)

Grade Group Gleason Score Gleason Pattern(s)
1 ≤6 ≤3 + 3
2 7 3 + 4
3 7 4 + 3
4 8 4 + 4 (3+5/5+3)
5 9 or 10 4 + 5, 5 + 4, 5 + 5

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!