Prostate cancer Gleason score

Recommend a treatment for initial treatment of prostate cancer based on stage, Gleason score, age, and symptoms. 

The initial treatment for prostate cancer depends primarily on the disease stage, the Gleason score, the presence of symptoms, and the life expectancy of the patient.15,26 Prostate cancer usually... 

Individuals with T2b and T2c disease or a Gleason score of 7 or a PSA ranging from 10 to 20 ng/mL (10 to 20 mcg/L) are considered at intermediate risk for prostate cancer recurrence.26 Individuals with less than a 10-year expected survival may be offered expectant managment, radiation therapy, or radical prostatectomy, and those with a greater than or equal to 10-year life expectancy may be offered either radical prostatectomy or radiation therapy (Table 89-5). 

Prostate cancer treatment depends on the stage, age, Gleason score, and PSA concentration. Treatment options include expectant management, radiation therapy, radical prostatectomy, hormonal therapy, and chemotherapy. 

The mean number of microscopic blood vessels in tissue is higher in prostate cancer and prostatic intraepithelial neoplasia (PIN) than normal prostate tissue. In a study evaluating microvessel density (MVD) on needle biopsy the authors found MVD, when combined with Gleason score and preoperative PSA, provided improved ability to predict extraprostatic extension at radical prostatectomy. " Although microvessel density was significant in the multivariate analysis, Gleason score and serum PSA were much more powerful predictors of extraprostatic... 

Bethel GR, Faith D, Li X, et al. Decreased NKX3.1 protein expression in focal prostatic atrophy, prostatic intraepithelial neoplasia, and adenocarcinoma association with gleason score and chromosome 8p deletion. Cancer Res. 2006 66 10683. 

Sanchez D, Rosell D, Honorato B, et al. Androgen receptor mutations are associated with Gleason score in localized prostate cancer. B]U Int. 2006 98 1320. 

Partin AW, Steinberg GD, Pitcock RV, et al. Use of nuclear morphometry, Gleason histologic scoring, clinical stage, and age to predict disease-free survival among patients with prostate cancer. Cancer. 1992 70 161. 

Krauss DJ, Hayek S, Amin M, Ye H, Kestin LL, Zadora S, Vicini FA, Cotant M, Brabbins DS, Ghilezan MI, Gustafson GS, Martinez AA. Prognostic significance of neuroendocrine differentiation in patients with Gleason score 8-10 prostate cancer treated with primary radiotherapy. Int J Radiat Oncol Biol Phys. 2011 81(3) E119-25. 

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