How is life expectancy related to the Gleason score? | What is the life expectancy of prostate cancer?

How is life expectancy related to the Gleason score?

Together with the PSA level and TNM classification, the Gleason Score can determine the prognosis for prostate cancer. To determine the Gleason Score, the stages of cell degeneration are examined under a microscope after removal of prostate tissue (biopsy). This is because cancerous tumors no longer show the normal tissue stratification in the histological image.

To determine the Gleason Score, the worst and the most frequent value found in the tissue sample are added together. The lowest degree of degeneration is 1 and the highest 5, so that in the worst case a Gleason score of 10 can occur. A Gleason score of > 8 indicates a fast and aggressive growing carcinoma.

A low Gleason score is a more favorable prognosis. Risk of developing a recurrence: With palliative treatment of prostate cancer, a mortality rate of less than 25% with a Gleason score of up to 6, 50% with a Gleason score of 7, and 75% with a Gleason score above 8.

  • Low risk with Gleason score up to 6 and/or PSA up to 10 ng/ml
  • Mean risk with Gleason score of 7 and/or PSA greater than 10 ng/ml to 20 ng/ml
  • High risk with Gleason score above 8 and/or PSA above 20 ng/ml

How is life expectancy related to PSA levels?

PSA stands for “prostate specific antigen”, i.e. this enzyme is produced exclusively in the prostate. The value is checked for early detection, to assess the course of treatment and to classify the tumor. Therefore, this value is indirectly related to life expectancy because it is used to classify the tumor as high-risk or low-risk or to check the success of the therapy initiated.

It is a protein that can be determined in blood serum. However, it not only indicates prostate carcinoma, but is also elevated in infections, urinary retention or benign prostate enlargement. The normal value is less than 4 ng/ml.

In order to be able to estimate whether a relapse will occur, the tumor stage, the Gleason Score and the PSA value are useful for prognosis. A PSA value below 10 ng/ml is associated with a low risk of recurrence, below 20 ng/ml with a medium risk and above 20 ng/ml with a high risk of recurrence.In the event of a relapse, i.e. the recurrence of cancer, the prognosis worsens and life expectancy decreases. However, it is not possible to make an exact temporal estimate of life expectancy based on the changing PSA values. or generally to the PSA value.