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Stage Information for Prostate Cancer

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Table 2. Pathologic (pT)a,b

a Reprinted with permission from AJCC: Prostate. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 457-68.
b There is no pathologic T1 classification.
c Positive surgical margin should be indicated by an R1 descriptor (residual microscopic disease).
pT2Organ confined.
pT2aUnilateral, ?one-half of one side.
pT2bUnilateral, involving >one-half of side but not both sides.
pT2cBilateral disease.
pT3Extraprostatic extension.
pT3aExtraprostatic extension or microscopic invasion of bladder neck.c
pT3bSeminal vesicle invasion.
pT4Invasion of rectum, levator muscles, and/or pelvic wall.

Table 3. Regional Lymph Nodes (N)a

a Reprinted with permission from AJCC: Prostate. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 457-68.
Clinical
NXRegional lymph nodes were not assessed.
N0No regional lymph node metastasis.
N1Metastases in regional lymph node(s).
Pathologic
pNXRegional nodes not sampled.
pN0No positive regional nodes.
pN1Metastases in regional node(s).

Table 4. Distant Metastasis (M)a,b

a Reprinted with permission from AJCC: Prostate. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 457-68.
b When more than one site of metastasis is present, the most advanced category is used. pM1c is most advanced.
M0No distant metastasis.
M1Distant metastasis.
M1aNonregional lymph node(s).
M1bBone(s).
M1cOther site(s) with or without bone disease.

Table 5. Anatomic Stage/Prognostic Groupsab

PSA = prostate-specific antigen.
a Reprinted with permission from AJCC: Prostate. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 457-68.
b When either PSA or Gleason is not available, grouping should be determined by T stage and/or either PSA or Gleason as available.
GroupTNMPSAGleason
IT1a-cN0M0PSA <10Gleason ?6
T2aN0M0PSA <10Gleason ?6
T1-2aN0M0PSA XGleason X
IIAT1a-cN0M0PSA <20Gleason 7
T1a-cN0M0PSA ?10 <20Gleason ?6
T2aN0M0PSA ?10 <20Gleason ?6
T2aN0M0PSA <20 Gleason 7
T2bN0M0PSA <20Gleason ?7
T2bN0M0PSA XGleason X
IIBT2cN0M0Any PSAAny Gleason
T1-2N0M0PSA ?20Any Gleason
T1-2N0M0Any PSAGleason ?8
IIIT3a-bN0M0Any PSAAny Gleason
IVT4N0M0Any PSAAny Gleason
Any T N1M0Any PSAAny Gleason
Any TAny NM1Any PSAAny Gleason

References:

  1. Oesterling JE, Martin SK, Bergstralh EJ, et al.: The use of prostate-specific antigen in staging patients with newly diagnosed prostate cancer. JAMA 269 (1): 57-60, 1993.
  2. Huncharek M, Muscat J: Serum prostate-specific antigen as a predictor of radiographic staging studies in newly diagnosed prostate cancer. Cancer Invest 13 (1): 31-5, 1995.
  3. Oesterling JE, Brendler CB, Epstein JI, et al.: Correlation of clinical stage, serum prostatic acid phosphatase and preoperative Gleason grade with final pathological stage in 275 patients with clinically localized adenocarcinoma of the prostate. J Urol 138 (1): 92-8, 1987.
  4. Daniels GF Jr, McNeal JE, Stamey TA: Predictive value of contralateral biopsies in unilaterally palpable prostate cancer. J Urol 147 (3 Pt 2): 870-4, 1992.
  5. Schuessler WW, Pharand D, Vancaillie TG: Laparoscopic standard pelvic node dissection for carcinoma of the prostate: is it accurate? J Urol 150 (3): 898-901, 1993.
  6. Stone NN, Stock RG, Unger P: Indications for seminal vesicle biopsy and laparoscopic pelvic lymph node dissection in men with localized carcinoma of the prostate. J Urol 154 (4): 1392-6, 1995.
  7. Fournier GR Jr, Narayan P: Re-evaluation of the need for pelvic lymphadenectomy in low grade prostate cancer. Br J Urol 72 (4): 484-8, 1993.
  8. Smith JA Jr, Scardino PT, Resnick MI, et al.: Transrectal ultrasound versus digital rectal examination for the staging of carcinoma of the prostate: results of a prospective, multi-institutional trial. J Urol 157 (3): 902-6, 1997.
  9. Gerber GS, Goldberg R, Chodak GW: Local staging of prostate cancer by tumor volume, prostate-specific antigen, and transrectal ultrasound. Urology 40 (4): 311-6, 1992.
  10. Hanks GE, Krall JM, Pilepich MV, et al.: Comparison of pathologic and clinical evaluation of lymph nodes in prostate cancer: implications of RTOG data for patient management and trial design and stratification. Int J Radiat Oncol Biol Phys 23 (2): 293-8, 1992.
  11. Schiebler ML, Yankaskas BC, Tempany C, et al.: MR imaging in adenocarcinoma of the prostate: interobserver variation and efficacy for determining stage C disease. AJR Am J Roentgenol 158 (3): 559-62; discussion 563-4, 1992.
  12. Consensus conference. The management of clinically localized prostate cancer. JAMA 258 (19): 2727-30, 1987.
  13. Schiebler ML, Schnall MD, Pollack HM, et al.: Current role of MR imaging in the staging of adenocarcinoma of the prostate. Radiology 189 (2): 339-52, 1993.
  14. Jewett HJ: The present status of radical prostatectomy for stages A and B prostatic cancer. Urol Clin North Am 2 (1): 105-24, 1975.
  15. Prostate. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 457-68.
  16. Montie JE: Staging of prostate cancer: current TNM classification and future prospects for prognostic factors. Cancer 75 (7 Suppl): 1814-1818, 1995.
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Last Updated: May 16, 2012
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