Gleason 7.6

Perhaps this is already been thought of, but when reporting gleason scores, particularly gleason 7, ie 3+4 OR 4+3, why can't it be made more simplified.
I know there are always two components to gleason 7, and this is called the gleason differential, thus being the percentage of grade 4 cells within the count or gleason score.
Would it not be more precise and helpful to break it down even further ie
a gleason score of 3+4=7 with a gleason differential of 40% grade 4 cells, could be denominated as gleason 7.4. This would then surely give a more accurate measurement for future decision making re treatment and prognosis.
So gleason 7 could be reported as;
10% grade 4 cells = gleason 7.1
20% " " " 7.2
30% " " " 7.3
40% " " " 7.4
50% " " " 7.5
60% " " " 7.6 [Thats me]
70% " " " 7.7
80% " " " 7.8
90% " " " 7.9
Gleason 8.

I believe most pathology reports do list the percentage of grade 4 cells within the tumor, so it is pretty easy to calculate.
Please correct me if I'm wrong, but I have always wondered why it is not done this way.
Sorry guys I obviously have too much time on my hands..........Kev

Post Edited (NotHard) : 12/20/2010 11:36:26 PM (GMT-7)

TB- Perhaps make any inquiry with your pathologist as to your percentage of grade 4 cells. I am pleased you like my idea, hopefully other members will see it and start using the system in their signatures, it just might catch on.
I certainly hope I'm not re-inventing the wheel here. Perhaps we can call it the Nothard score, because its really "Not-Hard"...................lol...................Kev

Hi NotHard,

Seems like a great idea to me, however, right now I like telling myself that I had 95% 3 and 5% 4 cells .

With your system I would probably get a rude awakening :-(.

Hope all is well with you and have a great holiday season.

Mag

 

Fairwind, I think you are missing my point. I am not talking about the general grading system as in grade 3,4 & 5. I am purely talking about gleason 7 and its current grading system of 3+4 and 4+3. My suggestion of a new grading system is only relevant to gleason 7, way on grading. My suggestion offers a more precise grading and I think would be helpful in differentiating the degree of potential aggressiveness and subsequent treatment protocols

Post Edited (NotHard) : 12/20/2010 11:23:45 PM (GMT-7)

Knotreel - If you look on your pathology report you will see or should see that the pathologist has already estimated the amount of grade 4 cells within your specimen. I am not suggesting this is a more accurate way of the pathologist reaching his analysis of the percentage of cells. It simply identify s the patient as to a more definite grading, which I believe would more very helpful to oncologists etc, when further treatment is necessary.

There are 2 schools of thought on your question, fairwind. Some say that all Gleason 7's should be treated as Gleason 8, because of the 4 component, and some say that a 3+4 is less dangerous than a 4+3. I hold to the first view, any 4 cells are agressive and unpredicable. I thought when my 4+3 was downgraded to 3+4, I might be able to buy some years before any chance of recurrance, but it happend to me in about 9 months.