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staging of prostate cancer

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 D1: pelvic nodal involvement 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

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Gleason scoring system for prostate cancer prostate cancer

General

staging of cancer

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 554-55
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  3. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 674-676