Posted 5/1/2017 8:50 PM (GMT 0)
Enrico,
The first number is the type of cancer cell that the pathologist sees the most of. The second number is the type of cancer of which he sees quite a bit but less than half. If it seems to be all (or mostly all) the same type then that type is written twice.
So Gleason 7(3+4) means that more than half of the cancer cells seen are the usually-less-aggressive type three cells but that there are a significant number of the more-aggressive type four cells present as well. This is sometimes called "low-intermediate" risk.
Gleason 7(4+3) means that the majority of the cancer cells are the more-aggressive type but that there are some less-aggressive type three cells mixed in, too. This is sometimes called "high-intermediate" risk.
If all (or mostly all) of the cancer cells are type three then that is low-risk Gleason 6(3+3) and if they are all higher-risk type four then that is Gleason 8(4+4).