Tumor Grading Systems
The NCCN guidelines stratify prostate cancer by risk. The risk groups are based on the staging of the prostate cancer, the Gleason score, PSA, and number and extent of biopsy cores positive for cancer. The risk stratification may help decide what treatment option is best for each individual.
Very low risk: stage T1c, Gleason score = 6, Gleason grade group 1, PSA < 10 ng/mL, < 3 prostate biopsy cores positive for cancer, < 50% cancer in any core, PSA density < 0.15 ng/mL/g
Low risk: stage T1-T2a, Gleason score = 6, Gleason grade group 1, PSA < 10 ng/mL
Intermediate risk: stage T2b-T2c, Gleason score 3+4 = 7, Gleason grade group 2 or Gleason score 4+3=7, Gleason grade group 3, or PSA 10-20 ng/mL
High risk: stage T3a or Gleason score 8, Gleason grade group 4, or Gleason 9-10, Gleason grade group 5, PSA > 20 ng/mL