Diagnosis and staging of prostatic carcinoma

The more commonly encountered complaints and findings on physical examination in patients with prostatic carcinoma have been reviewed. An expansion and alteration of an established system of staging has been proposed. The expansion is related to the observation that bulky primary tumors are appreciably more often associated with nodal metastases than are small local tumors. The alteration is in giving consideration to hydronephrosis and elevation of the serum acid phosphatase as factors which influence survival. These measurements are conventional and easily obtained. They should be used in staging. It is obvious that no extant staging system provides for precision in describing a single patient nor a group of patients. Accordingly, comparisons between therapeutic regimens are impossible. We look forward to the publication of a useful “TNM” system from the American Joint Committee on Cancer Staging and the Union Internationale Contre le Cancer.