A 65-year-old male undergoes a prostate biopsy revealing adenocarcinoma. The pathologist assigns a Gleason score of 4+3=7. What does this score primarily indicate?

Explanation

The Gleason score is specific to prostate adenocarcinoma and is derived from the sum of the two most prevalent architectural patterns observed in the biopsy, with the primary (most common) pattern listed first. A score of 4+3=7 indicates that the most common pattern is moderately differentiated (pattern 4), and the second most common is also moderately differentiated (pattern 3). Pattern 4 is more aggressive than pattern 3. This signifies a moderately aggressive tumor. Higher scores indicate poorer differentiation and worse prognosis. Lymph node metastasis and tumor confinement are aspects of staging, not grading.