Prostate Staging Schemes
American Staging for Prostate Cancer
Pathologic staging with some clinical guidelines.
- Stage A can be subdivided based on the number of cell clusters (foci) seen on microscopic examination.
- The difference between Stage A and Stage B is whether nodule(s) are clinically palpable (or visibly seen) in prostate.
- Dividing line between Stage B and Stage C is capsular invasion microscopically.
- Stage D is metastatic disease identified either clinically or microscopically.
Guidelines for American Staging for Prostate:
- Stages A1, B1, C1, D1 correspond to T1, T2, T3, T4.
- Stages A and B are localized, Stage C regionalized, Stage D distant.
Gleason's Score/system for Grading of Prostate Cancer
First proposed in 1966 by Donald F. Gleason, a pathologist at the University of Minnesota in Minneapolis, MN.
A pathologic classification only. Based on the premise that poorly-differentiated tumors are more aggressive and unpredictable than well-differentiated tumors. Gleason's score is not a staging system.
- Pathologist reviews specimen microscopically and observes whether the malignant cells are similar in structure to the tissue of origin. The closer to the original tissue, the better differentiated.
- Pathologist looks for a primary predominant pattern for cells, and a secondary or lesser pattern. Each is given a score from 1 to 5.
- Scores for primary and secondary patterns are added together to achieve the Gleason score for the tumor. Scores can range from 2 (uniformly well differentiated 1 + 1) to 10 (diffusely anaplastic 5 + 5)