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Gleaso score of 3 +4; does percent of 3 versus percent of 4 matter?
If 3 makes up 90 percent of the 3+4 and 4 makes up 10 percent are the implications different than if 3 makes up 51 percent and 4 is 49 percent?
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Yes, the lower the percent of 4 the better. Even though the score is done by percentages the actual risk is continuous and 4+3 goes into the same grade group as 4+4 (GG3) while 3+4 is GG2. GG2 has better results (less recurrence) regardless of treatment be it RP, radiation or focal (this is still high but less than 4+3). Can still consider active surveillance if Decipher score is low and there were no aggressive indications in the biopsy notes.
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Hug
1 ReactionAs @jim18 Says, Active surveillance is what you really should consider first. One thing you don’t discuss is how many 3+4 cores were found. Were any 3+3 cores found?
If they were more than five of those, then treatment may be recommended.
The decipher score can tell a lot.
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Hug
2 Reactions@jim18 Aren’t Gleason 7(4+3) and Gleason 8(4+4) in different Grade Groups?
Isn’t it:
Gleason 6: GG1
Gleason 7(3+4): GG2
Gleason 7(4+3): GG3
Gleason 8: GG4
Gleason 9/10: GG5
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1 Reaction@brianjarvis Yes, I was thinking of the stages where IIC and IIIA treat 4+3 and 4+4 the same provided it is all still local.
@jim18 4+4 is GG 4 and 4+3is GG 3
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1 ReactionWhat is your age and PSA?
Age 79, PSA 12
@jeffmarc one core in the lesion was 3+4; the other 11 cores were benign.
@jeffmarc thanks; I day decipher results May 5.
That was supposed to be ‘I get’ not ‘ I day’…sorry