tertiary Gleason grade

tertiary Gleason grade

A term of art referring to the presence of a small component of high-grade (e.g., Gleason grade-5) histological pattern of conventional prostate carcinoma, which is seen in a biopsy or resection of prostate tissue that has lower primary and secondary grades (e.g., Gleason score of 4 + 3 = 7). The significance of a high-grade tertiary component is uncertain, but generally believed to worsen the patient’s prognosis.

Tertiary Gleason is defined as either:
(1) Any small amount of Gleason grade-4 or -5 tissue in a specimen from a patient who otherwise has a Gleason score of 3 + 3 = 6 or lower; or
(2) Any small amount of Gleason grade-5 tissue in a specimen from a patient who otherwise has a Gleason score of 3 + 4 = 7, 4 + 3 = 7, or 4 + 4 = 8.

Patients who have Gleason scores of 9 or 10 can not, by definition, have a clinically significant, tertiary Gleason grade.
References in periodicals archive ?
Furthermore, if there was a tertiary Gleason grade in the prostatectomy tissue, the proportion of tertiary grade tissue was documented.
8) The authors stated that the presence of the tertiary Gleason grade in tumors with a Gleason score of 6 and 7 had a negative effect on the pathological stage and biochemical relapse-free survival.
Therefore, the presence of a tertiary Gleason grade in the pathological specimens is not uncommon.
The authors reported that in Gleason score 6 and 7 tumors, the presence of the tertiary Gleason grade had a negative impact on the pathological stage and biochemical relapse-free survival.
16) reported a higher rate of biochemical recurrence and a shorter biochemical progression time in patients with a Gleason score (GS) of 4+3 in the presence of a tertiary Gleason grade (TGG) 5.
19) argued that the presence of any high tertiary Gleason grade was an independent predictor for PSA recurrence and treatment failure in all patterns.
21) detected a tertiary Gleason grade in 36 patients (16.
The prevalence of a tertiary Gleason grade in the study of Isbarn et al.
According to all the above-mentioned studies, the tertiary Gleason grade is an indication of the aggressiveness of the biological behavior of the tumor.
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