Talk:Gleason grading system

Prognosis needed

Something could be added here about the significance of the Gleason score in terms of treatment/mortality etc. Is it appropriate to just copy sections directly from relevant other pages? —The preceding unsigned comment was added by Wrongfooting (talk • contribs) 21:27, 15 March 2007 (UTC).

Is there a score for the overall Prostate, and not just he individual samples? Given the range of Gleason scores for the 12 or 16 samples, how is an overall prognosis for the prostate developed? This issue seems not to be addressed in the article anywhere and yet seems relatively important for a patient.Imersion (talk) 10:25, 6 June 2015 (UTC)

Yes, the whole point of the Gleason score was to quantify the risks of getting prostate cancer and dying of it.

Urologists could say, "You have a 10% chance of developing prostate cancer in the next 10 years without surgery, and a 1% chance of death and 50% chance of sexual impotence with surgery. Which would you prefer?"

Leaving out the actual incidence and mortality statistics for the Gleason score is like Hamlet without Hamlet.

There was a recent review of prostate cancer screening in the NEJM which should discuss it. --Nbauman (talk) 20:10, 9 August 2015 (UTC)

Could use more detail on distinguishing score from grade

Regarding:

"A pathologist examines the biopsy specimen and attempts to give a score to the two most prominent patterns. These scores are then added to obtain the final Gleason score. For example, a prostate biopsy specimen may exhibit two different patterns, one which is assigned a number two and the other a number three. The final Gleason score in this case would be five."

The basic measure is the grade, and the sum is the score. See: http://www.phoenix5.org/Infolink/GleasonGrading.html or http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.47293/k.D232/Diagnosis.htm

The score is the sum of the most predominant grade and the second most predominant. A score of 7 can be expressed as 3 + 4 or 4 + 3, and the latter is considered more serious.

Some more details on biopsy could be considered. It is typical (at least where I live) to take 16 samples, but there is still a 25% probablity of false negative (that figure would need to be validated). The Gleason score can be established from biopsy samples and from post-operative pathology, and the score can be different between the two.

Recommend there also be a link to the Prostate Cancer Foundation. http://www.prostatecancerfoundation.org/ and Us TOO, the International Prostate Cancer Education and Support Network http://www.ustoo.com/. The reader may just have been diagnosed and might need all the information and support he can find. I was in that situation not so long ago.

Dharmadoggie 19:37, 14 June 2007 (UTC)

Excellent point. The Gleason scale is not just as set out in the main page. In developing his system, Dr Gleason discovered that by giving a combination of the grades of the two most common patterns he could see in any particular patient's specimens, he was better able to predict the likelihood that that particular patient would do well or badly. Therefore, the Gleason score is actually a combination or sum of two numbers. These combined Gleason sums or scores may be determined as follows:

1. The lowest possible Gleason score is 2 (1 + 1), where both the primary and secondary patterns have a Gleason grade of 1 and therefore when added together their combined sum is 2.

2. Very typical Gleason scores might be 5 (2 + 3), where the primary pattern has a Gleason grade of 2 and the secondary pattern has a grade of 3, or 6 (3 + 3), a pure pattern that is one of the most prevalent.

3. Another typical Gleason score might be 7 (3+ 4), where the primary pattern has a Gleason grade of 3 and the secondary pattern has a grade of 4.

4. Finally, the highest possible Gleason score is 10 (5 + 5), when the primary and secondary patterns both have the most disordered Gleason grades of 5.

In summary, with 5 Gleason grades there are 9 possible Gleason scores with 25 different combinations.

http://malecare.com/gleason-score_58.htm —Preceding unsigned comment added by 68.4.59.205 (talk) 05:43, 9 October 2007 (UTC)

Definitely agreed. Very unclear explanation of what the two grades actually are. The "most common cancer" ....of what? PhatRita (talk) 02:54, 26 December 2008 (UTC)

Typo Cleanup

Typo: debateable==>debatable Join Typo Team - You can help!Aclayartist (talk) 15:44, 5 November 2008 (UTC)

should link from Dendreon

GS and GS inflation and prognosis should be mentioned with Dendreon somehow. Their modelling was a big issue earlier and part of the controversy dealt with GS among other putative prognostic factors. I'm not sure secondary sources exist but there should be primary sources from both the company and FDA briefing documents. On a personal note, I would not suggest sending out slides of prostate histology as a substitute for christmas cards as I did on a DNDN message board a few years ago ( slow holiday time LOL). Nerdseeksblonde (talk) 22:16, 3 September 2009 (UTC)

page name

Is the name of this page not slightly confusing as the Gleason grading and score are measurements of histological findings (i.e. cell differentiation) representing a grading system and not spread of the tumour or "staging" system. —Preceding unsigned comment added by 91.110.182.189 (talk) 19:43, 9 December 2009 (UTC)

I very much agree. —Preceding unsigned comment added by 78.146.190.121 (talk) 12:10, 30 March 2010 (UTC)

Requested move

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the move request was: moved. Please discuss and move if appropriate if the capitalisation is decided upon. PeterSymonds (talk) 12:14, 7 April 2010 (UTC)

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Gleason staging system → Gleason Grading System — The Gleason system is regarding the degree of differentiation of a tumour, and hence qualifies as a grading, not staging system. 78.146.190.121 (talk) 12:21, 30 March 2010 (UTC)

• Support, that appears to be the most common name for it, but most sources I saw used the lowercase Gleason grading system. Recury (talk) 20:27, 30 March 2010 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

does not reflect the change to the Gleason grading system made in 2014 (I think it was)

quote:

In contrast to the original Gleason grading system, it is now recommended that on a needle core biopsy both the most common and highest grade are added together for the Gleason score [2]. For example, if there is 60 % Gleason pattern 3, 35 % Gleason pattern 4, and 5 % Gleason pattern 5, the Gleason score would be 3 + 5 = 8. Needle core biopsy is an imperfect, non-targeted, random sampling of the prostate gland. Thus any amount of high-grade tumor sampled on needle biopsy most likely indicates a more significant amount of high-grade tumor within the prostate.

end of quote .. citation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784293/ ( Martin | talk • contribs 17:41, 4 October 2017 (UTC))

This is how it is described in section "Scores and prognoses", while under "Comments" it says "The second feature of Gleason grading is that the grade is not based on the highest (least differentiated) pattern within the tumor, instead it is a combination of the most often and second most often patterns seen." I am no expert and do not know which is correct, but this is an obvious contradiction.

Kai — Preceding unsigned comment added by 217.110.38.74 (talk) 12:53, 13 June 2018 (UTC)