PROSTATE CANCER STAGING
Tuesday, January 25, 2011
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TUMOR
TX: The primary tumor cannot be evaluated.
T0: There is no evidence of a tumor in the prostate.
T1: The tumor cannot be felt during the DRE and is not seen during imaging (any test that produces pictures of the inside of the body, such as a CT scan). It may be found when surgery is done for another reason, usually for BPH, or abnormal growth of benign prostate cells.
T1a: The tumor is in 5% or less of the prostate tissue removed through surgery.
T1b: The tumor is in more than 5% of the prostate tissue removed through surgery.
T1c: The tumor is found during a needle biopsy, usually because the patient has an elevated PSA level.
T2: The tumor is found only within the prostate, not other areas of the body. It is large enough to be felt during the DRE.
T2a: The tumor has invaded one-half of one lobe (part or side) of the prostate.
T2b: The tumor has spread to more than one-half of one lobe of the prostate, but not to both lobes.
T2c: The tumor has invaded both lobes of the prostate.
T3: The tumor has grown through the prostate capsule (into the tissue just outside the prostate on one side).
T3a: The tumor has grown through the prostate capsule either on one side or on both sides of the prostate or has spread to the neck of the bladder.
T3b: The tumor has invaded the seminal vesicle(s), the tube(s) that carry semen.
T4: The tumor is fixed, or it is invading nearby structures besides the seminal vesicles, such as the external sphincter (part of the muscle layer that helps to control urination), the rectum, levator muscles, and/or the pelvic wall.
NODES
NX: The regional lymph nodes cannot be evaluated.
N0: The cancer has not spread to the regional lymph nodes.
N1: The cancer has spread to the regional lymph node(s).
DISTANT METASTASIS
MX: Distant metastasis cannot be evaluated.
M0: The disease has not metastasized.
M1: There is distant metastasis.
M1a: The cancer has invaded nonregional, or distant, lymph node(s).
M1b: The cancer has invaded bone(s) in the body.
M1c: The cancer has spread to another part of the body, with or without spread to the bone.
PROGNOSTIC FACTORS
PSA-GLEASON SCORE-STAGE
GLEASON SCORE
Gleason X: The Gleason score cannot be determined.
Gleason 6 or lower: The cells are well-differentiated.
Gleason 7: The cells are moderately differentiated.
Gleason 8, 9, or 10: The cells are poorly differentiated or undifferentiated .
STAGE GROUPING
TX: The primary tumor cannot be evaluated.
T0: There is no evidence of a tumor in the prostate.
T1: The tumor cannot be felt during the DRE and is not seen during imaging (any test that produces pictures of the inside of the body, such as a CT scan). It may be found when surgery is done for another reason, usually for BPH, or abnormal growth of benign prostate cells.
T1a: The tumor is in 5% or less of the prostate tissue removed through surgery.
T1b: The tumor is in more than 5% of the prostate tissue removed through surgery.
T1c: The tumor is found during a needle biopsy, usually because the patient has an elevated PSA level.
T2: The tumor is found only within the prostate, not other areas of the body. It is large enough to be felt during the DRE.
T2a: The tumor has invaded one-half of one lobe (part or side) of the prostate.
T2b: The tumor has spread to more than one-half of one lobe of the prostate, but not to both lobes.
T2c: The tumor has invaded both lobes of the prostate.
T3: The tumor has grown through the prostate capsule (into the tissue just outside the prostate on one side).
T3a: The tumor has grown through the prostate capsule either on one side or on both sides of the prostate or has spread to the neck of the bladder.
T3b: The tumor has invaded the seminal vesicle(s), the tube(s) that carry semen.
T4: The tumor is fixed, or it is invading nearby structures besides the seminal vesicles, such as the external sphincter (part of the muscle layer that helps to control urination), the rectum, levator muscles, and/or the pelvic wall.
NODES
NX: The regional lymph nodes cannot be evaluated.
N0: The cancer has not spread to the regional lymph nodes.
N1: The cancer has spread to the regional lymph node(s).
DISTANT METASTASIS
MX: Distant metastasis cannot be evaluated.
M0: The disease has not metastasized.
M1: There is distant metastasis.
M1a: The cancer has invaded nonregional, or distant, lymph node(s).
M1b: The cancer has invaded bone(s) in the body.
M1c: The cancer has spread to another part of the body, with or without spread to the bone.
PROGNOSTIC FACTORS
PSA-GLEASON SCORE-STAGE
GLEASON SCORE
Gleason X: The Gleason score cannot be determined.
Gleason 6 or lower: The cells are well-differentiated.
Gleason 7: The cells are moderately differentiated.
Gleason 8, 9, or 10: The cells are poorly differentiated or undifferentiated .
STAGE GROUPING
Stage | T | N | M |
I | T1a, T1b, or T1c | N0 | M0 |
T2a | N0 | M0 | |
Any T1 or T2a | N0 | M0 | |
IIA | T1a, T1b, or T1c | N0 | M0 |
T1a, T1b, or T1c | N0 | M0 | |
T2a | N0 | M0 | |
T2b | N0 | M0 | |
T2b | N0 | M0 | |
IIB | T2c | N0 | M0 |
Any T1 or T2 | N0 | M0 | |
Any T1 or T2 | N0 | M0 | |
III | T3a or T3b | N0 | M0 |
IV | T4 | N0 | M0 |
Any T | N1 | M0 | |
Any T | Any N | M1 |
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