The Gleason system records the two most common histological architectures of prostate cancer, each scored from 1 (well differentiated) to 5 (poorly differentiated). The total score therefore ranges from 6 to 10. Because raw scores like 7 can arise from either a 3+4 or a 4+3 pattern with different outcomes, the ISUP introduced five prognostic Grade Groups.
Mapping: $3+3=6 \rightarrow$ Group 1; $3+4=7 \rightarrow$ Group 2; $4+3=7 \rightarrow$ Group 3; $4+4, 3+5, 5+3 = 8 \rightarrow$ Group 4; $9$ and $10 \rightarrow$ Group 5.
Here the report is $4+4$, summing to $8$, with both components being aggressive pattern 4 tissue. This places it squarely in Grade Group 4, signalling high-risk disease.
\[\boxed{\text{Gleason } 4+4 = \text{Grade Group 4}}\]