What Gleason score range indicates the worst prognosis?

A Gleason score is a grading system used to assess the aggressiveness of prostate cancer by evaluating the architectural patterns of cancer cells. The score ranges from 2 to 10, based on the sum of the two most prevalent patterns observed in the biopsy.

A score of 8-10 indicates a high Gleason score, which correlates with a more aggressive disease and a worse prognosis. This higher score reflects more poorly differentiated tumor cells that are likely to grow more rapidly and spread more extensively. Patients with higher Gleason scores have a significantly elevated risk of metastasis and a poorer likelihood of survival compared to those with lower scores.

In contrast, scores from 1-3 indicate very well-differentiated cells, suggesting the cancer is less aggressive. Scores from 4-6 represent moderately differentiated cells, and while these suggest a more aggressive potential than the lowest scores, they do not pose as severe a risk as the scores of 8-10. Therefore, the highest scores bear the most concern and are indicative of a dire prognosis due to the aggressive nature of the disease.