A 65-Year-Old Man Has a Routine Screening Examination, and His

A 65-year-old man has a routine screening examination, and his serum prostate- specific antigen (PSA) level is found to be 6.7 ng/mL. Digital rectal examination reveals a mildly enlarged prostate gland, but no discrete nodules. One year ago, his PSA was 2.1 ng/mL. The patient is referred to a urologist who performs a biopsy of the gland. Biopsy specimen shows adenocarcinoma of the prostate with a Gleason score of 9. Which of the following best describes his prognosis on the basis of his Gleason score?

A) The Gleason score is not reproducible and should not be used as a prognostic variable.
B) Because the patient is asymptomatic, the Gleason score will not be predictive of outcome.
C) The Gleason score indicates that the patient would have a high risk of recurrence after a radical prostatectomy.
D) The Gleason score indicates that the patient would have a very low risk of recurrence after radiation therapy.