What grading system is used to classify prostate cancer?

The Gleason score is the grading system used to classify prostate cancer based on the histological appearance of prostate cancer cells. It evaluates the patterns of cancer cells in tissue samples obtained through biopsy. The score ranges from 2 to 10, derived by adding two grades together, each ranging from 1 to 5. The first number corresponds to the most prevalent pattern of cancer cells observed, and the second number corresponds to the second most common pattern. This classification helps to predict the aggressiveness of the cancer and inform treatment decisions.

The significance of the Gleason score lies in its strong correlation with the prognosis of prostate cancer. Higher scores indicate more poorly differentiated, aggressive tumors that are more likely to grow and spread quickly, necessitating more rigorous treatment strategies. In contrast, lower scores suggest well-differentiated tumors that are generally less aggressive, often leading to closer monitoring rather than immediate intervention.

The other grading systems mentioned do not apply to prostate cancer. For instance, the Fletcher score and Broders score are used for different types of cancers or conditions, while the Richter score is related to the transformation of chronic lymphocytic leukemia into aggressive lymphoma. This specificity of the Gleason score makes it critical in clinical practice for prostate cancer management.