staging of prostate cancer
Introduction
TNM staging for prostate cancer
T1a: incidentally detected tumor, < 5% of resected tissue
T1b: incidentally detected tumor, > 5% of resected tissue
T1c: impalpable tumor, detected by needle biopsy
T2a: tumor confined to prostate, < 50% of 1 lobe involved
T2b: tumor confined to prostate, > 50% of 1 lobe involved
T2c: tumor confined to prostate, both lobes involved
T3a: unilateral extension through prostate capsule
T3b: bilateral extension through prostate capsule
T3c: tumor invades seminal vesicles
T4a: tumor invades bladder neck, external sphincter, or rectum
T4b: tumor invades levator ani muscle &/or fixes to pelvic wall
N1: metastasis to lymph node, < 2 cm in diameter
N2: metastasis to lymph node, 2 < 5 cm in diameter
N3: metastasis to lymph node, > 5 cm in diameter
M1: distant metastases
ABCD staging for prostate cancer
A1(T1a): incidentally detected tumor, < 5% of resected tissue
A2(T1b): incidentally detected tumor, > 5% of resected tissue
T1c: impalpable tumor, detected by needle biopsy
B1(T2a): tumor confined to prostate, < 50% of 1 lobe involved
B2(T2b): tumor confined to prostate, > 50% of 1 lobe involved
B3(T2c): tumor confined to prostate, both lobes involved
C(T3): extracapsular local disease
D2: distant metastases
AJCC stage grouping for prostate cancer*
Stage 1: T1a, N0, M0, G1
Stage 2:
- T1a, N0, M0, G2-4
- T1b, N0, M0,any G
- T1c, N0, M0, any G
- T2, N0, M0, any G
Stage 3: T3, N0, M0, any G
Stage 4:
- T4, N0, M0, any G
- Any T, N1, M0, any G
- Any T, any N, M1, any G
* G = Gleason score
Risk for recurrence based on initial staging
| Risk | stage | Gleason score | PSA |
|---|---|---|---|
| Low risk | T1-T2a | G=2-6 | PSA <= 10 ug/L |
| Intermediate risk | T2b,T2c | G=7 | PSA 10-20 ug/L |
| High risk | T3a | G=8-10 | PSA >= 20 ug/L |
More general terms
Additional terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 554-55
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 674-676