Gleason score 7 prostate cancer: A heterogeneous entity? Correlation with pathologic parameters and disease-free survival

Wael A. Sakr, Marcos V. Tefilli, David J. Grignon, Mousumi Banerjee, Jyotirmoy Dey, Edward L. Gheiler, Rabi Tiguert, Isaac J. Powell, David P. Wood

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115 Scopus citations


Objectives. Gleason score 7, in different proportions of grades 3 and 4, is the score most frequently assigned to prostate cancer in our radical prostatectomy specimens (RPSs). We correlated the major grade component of score 7 tumors with clinicopathologic parameters and disease-free survival.Methods. All Gleason score 7 RPSs were classified as having a major grade of 3 or 4 carcinoma. The two groups were compared according to patient age, race, serum prostate-specific antigen (PSA) level, clinical and pathologic stage, tumor volume, and biochemical recurrence.Results. Of the 534 patients analyzed, 356 and 178 had major grade 3 or 4 tumors, respectively. Compared with patients with 3+4 tumors, those with 4+3 had significantly more advanced clinical and pathologic stages, larger tumor volume, higher preoperative PSA levels, and older age and a higher proportion were African American (P <0.05 for all above parameters). With a mean follow-up of 34.6 months, patients with 3+4 tumors experienced lower rates of PSA recurrence than did those with 4+3 tumors (P = 0.0021). Furthermore, for the subset of patients with organ-confined disease, multivariable analysis that included race, age, clinical stage, preoperative PSA level, tumor volume, and major grade component found only the latter to be a significant predictor of recurrence, with patients who had major grade 4 component tumors experiencing a higher incidence of PSA recurrence than those with major grade 3 tumors (P = 0.012).Conclusions. The major grade 4 component in Gleason score 7 carcinoma indicates a higher likelihood of biochemical recurrence, particularly for the increasing proportion of patients with organ-confined disease after radical prostatectomy. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)730-734
Number of pages5
Issue number5
StatePublished - Nov 8 2000


ASJC Scopus subject areas

  • Urology

Cite this

Sakr, W. A., Tefilli, M. V., Grignon, D. J., Banerjee, M., Dey, J., Gheiler, E. L., Tiguert, R., Powell, I. J., & Wood, D. P. (2000). Gleason score 7 prostate cancer: A heterogeneous entity? Correlation with pathologic parameters and disease-free survival. Urology, 56(5), 730-734.