A 67-Year-Old Man Comes to the Physician Because of Worsening

A 67-year-old man comes to the physician because of worsening lower back pain for 6 weeks. He reports that the pain is most intense with movement and that it sometimes occurs at night. Over the past 3 months, he has noticed a weakened urinary stream. He has not seen any blood in his urine. His only daily medication is ibuprofen, which does not provide adequate pain relief. Examination shows no spinal deformities. Digital rectal examination reveals a firm prostatic nodule. The patient undergoes transrectal prostate biopsy, and microscopy reveals sheets of tumor cells infiltrating the stroma with no glandular differentiation; the tumor cells have large vesicular nuclei and prominent nucleoli.  Imaging shows enlargement of several iliac lymph nodes.  Which of the following is the best description of this patient's tumor?

A) Higher-Gleason score and higher stage
B) Higher-Gleason score and lower-stage
C) Lower-Gleason score and higher-stage
D) Lower-Gleason score and lower-stage