{"id":2523,"date":"2009-03-05T18:36:19","date_gmt":"2009-03-05T18:36:19","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/uroprost\/"},"modified":"2025-05-14T19:10:52","modified_gmt":"2025-05-14T19:10:52","slug":"uroprost","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/uroprost\/","title":{"rendered":"Staging of Prostate Cancer"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\"><strong> The Tumor-Node-Metastasis (TNM) System<\/strong><\/p>\n<p><!--more--><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"border: 1pt solid windowtext; padding: 0cm 5.4pt; width: 96px; text-align: center;\" valign=\"top\">\n<p class=\"MsoNormal\"><strong> Stage (TNM) <\/strong><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 341px; border: 1pt 1pt 1pt medium solid solid solid none windowtext windowtext windowtext -moz-use-text-color;\" valign=\"top\">\n<p class=\"MsoNormal\"><strong> Definition of Stage<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 96px; text-align: center;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T1<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T1a<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T1b<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T1c<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 341px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Not palpable, found following TURP or biopsy<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Focal, &lt;5% of tissue, not high grade<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Diffuse, &gt;5% of tissue, and\/or high grade<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Biopsy for PSA elevation only<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 96px; text-align: center;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T2<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T2a<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T2b<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T2c<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 341px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Palpable disease limited to the prostate<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Disease &lt; \u00bd of one lobe<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Disease &gt; \u00bd of one lobe but &lt; 1 lobe<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Disease &gt; 1 lobe<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 96px; text-align: center;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T3<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T3a<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T3b<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">T3c<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 341px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Palpable disease beyond the prostate<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Unilateral disease beyond the capsule<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Bilateral disease beyond the capsule<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Spread to seminal vesicles<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 96px; text-align: center;\" valign=\"top\">\n<p class=\"MsoNormal\">T4<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 341px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" valign=\"top\">\n<p class=\"MsoNormal\">Metastatic spread to adjacent organs (e.g., bladder, pelvic sidewall)<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding: 0cm 5.4pt; width: 96px; border: medium 1pt 1pt none solid solid -moz-use-text-color windowtext windowtext;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"text-align: center;\">Metastatic cancer<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 341px; border: medium 1pt 1pt medium none solid solid none -moz-use-text-color windowtext windowtext -moz-use-text-color;\" valign=\"top\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">N+ Tumor that has spread to pelvic lymph nodes<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">M+ Tumor that has spread beyond pelvic lymph nodes<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\">TURP = transurethral resection of the prostate; PSA = prostate-specific antigen.<\/p>\n<p class=\"MsoNormal\"><strong> The Gleason Grading System <\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">The Gleason histological scoring system, tumors are graded from one to five based upon the degree of glandular differentiation and structural architecture. Grade one represents the most well-differentiated appearance and grade five represents the most poorly differentiated. A primary score and a secondary score is then reported. The most differentiated cancers have a score of &#8220;one plus one&#8221; or two; the most undifferentiated cancers are scored as &#8220;five plus five&#8221; or ten. Combined scores (primary and secondary scores) of two, three, and four usually represent well-differentiated cancers; scores of five, six, or seven represent moderately differentiated cancers; and scores of eight, nine, or ten represent poorly differentiated cancers. The prognosis is directly related to the pattern score.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Grading System:<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>1<\/strong> Simple round glands, closely packed in rounded masses with well-defined edges.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>2<\/strong> Simple round glands, loosely packed in vague, rounded masses with loosely packed edges.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>3A<\/strong> Medium-sized single glands of irregular shape and irregular spacing with ill-defined infiltrating edges.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>3B<\/strong> Very similar to 3A, but small to very small glands which must not form significant chains or cords.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>3C<\/strong> Papillary and cribriform epithelium in smooth, rounded cylinders and masses; no necrosis.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>4A<\/strong> Small, medium, or large glands fused into cords, chains or ragged, infiltrating masses.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>4B<\/strong> Very similar to 4A, but with many large clear cells, sometimes resembling &#8220;hypernephroma.&#8221;<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>5A<\/strong> No glandular differentiation, solid sheets, cords, single cells, or solid nests of tumor with central necrosis.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 12px; margin-top: 0pt; margin-bottom: 0pt;\"><strong>5B<\/strong> Anaplastic adenocarcinoma in ragged sheets.<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<\/div>\n<ol>\n<li class=\"MsoNormal\">Rees MA, Resnick MI, Oesterling JE. Use of prostate-specific antigen, Gleason score, and digital rectal examination in staging patients with newly diagnosed prostate cancer. Urol Clin North Am. 1997 May;24(2):379-88. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9126235\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li class=\"MsoNormal\">Gleason DF. Histologic grading of prostate cancer: a perspective. Hum Pathol. 1992 Mar;23(3):273-9. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/1555838\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Jan 14, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[298],"tags":[322,1602,1405,1601,516,515,835,1600,1355],"class_list":["post-2523","post","type-post","status-publish","format-standard","hentry","category-urology","tag-cancer","tag-estadios","tag-oncology","tag-pathology","tag-prostata","tag-prostate","tag-staging","tag-tnm","tag-urology"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2523","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2523"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2523\/revisions"}],"predecessor-version":[{"id":9131,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2523\/revisions\/9131"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2523"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2523"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2523"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}