Is there a significant difference in prognosis between Gleason score 3 + 4 and 4 + 3 prostate cancers in radical prostatectomy specimens? What is the prognostic implication of Gleason score 3 + 4 versus 4 + 3 prostate cancer assigned to prostate needle core biopsy specimens?
Gleason score 3 + 4 signifies tumors with Gleason 3 component greater (>50%) than Gleason 4 component. In a Gleason 4 + 3 tumor, Gleason grade 4 component is dominant. In prostatectomy specimens, Gleason score 4 + 3 cancer is associated with a worse clinical outcome than Gleason score 3 + 4 cancer. Dividing a Gleason score 7 tumor to 3 + 4 and 4 + 3 on prostate needle core biopsy is useful only for predicting the final Gleason score in radical prostatectomy specimens. The score, however, does not necessarily correlate with Gleason 3 + 4 or 4 + 3 in the final diagnosis because of sampling issues. Nevertheless, pathologists should attempt to specify Gleason score 7 as either 4 + 3 or 3 + 4 to provide clinically relevant information.
KeywordsRadical Prostatectomy Seminal Vesicle Gleason Score Needle Core Biopsy Prostatectomy Specimen
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