Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging

No AccessJournal of Urology1 Feb 2002Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging Donald F. Gleason, George T. Mellinger, and The Veretans Administration Cooperative Urological Research Group Donald F. GleasonDonald F. Gleason , George T. MellingerGeorge T. Mellinger , and The Veretans Administration Cooperative Urological Research Group View All Author Informationhttps://doi.org/10.1016/S0022-5347(02)80309-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Histological grading of prostatic adenocarcinoma contributes mortality rate prediction information in addition to that provided by clinical staging of the tumor. Combined staging and grading seems to identify groups of patients with favorable survival experience as measured by followup mortality data in 1,032 patients. There were no cancer deaths for the 68 patients (6.5 per cent) in the lowest prognostic categories 4 to 6. For the 302 patients (29 percent) in categories 4 to 8, the cancer death rate was so low that a serious question arises as to whether they should be subjected to any potentially dangerous treatment unless (and until) signs or symptoms develop which indicate that they are actually suffering progression of their cancer. The data for stages III and IV patients with histologically low grade cancers suggest that these patients are at no greater risk of death from cancer than most stages I and II patients for whom radical prostatectomy has been recommended (and was performed in this study). Combined staging and grading identified groups of patients at increasing intermediate risks and showed that these patients had a distinct reduction in cancer mortality rates associated with the administration of DES. The use of grading plus staging also emphasized that little information as to response to treatment can be gained from patients with cancer of high biological malignancy until some effective treatment is developed. Cancers of low biological malignancy cannot be expected to reveal significant treatment differences. References 1. : Carcinoma of prostate: correlation between the histologic observations and clinical course. Arch. Path.1942; 34: 473. Google Scholar 2. : Transurethral resection of malignant lesions of the prostate gland. J.A.M.A.1942; 120: 1105. Google Scholar 3. : Conservative treatment of carcinoma of the prostate. J.A.M.A.1956; 160: 833. Google Scholar 4. : Carcinoma of the prostate. A new system of classification. Arch. Surg.1958; 77: 751. Google Scholar 5. : Endocrine therapy in carcinoma of the prostate gland: 10-year survival studies. J. Urol.1960; 83: 471. Link, Google Scholar 6. : Carcinoma of the prostate treated by radical prostatectomy. A clinicopathological survey of 187 cases followed for 5 years and 148 cases followed for 10 years. Cancer1963; 16: 1598. Google Scholar 7. : Prognostic value of grading prostatic carcinoma. J. Urol.1963; 89: 881. Link, Google Scholar 8. : The histology and prognosis of prostatic cancer. J. Urol.1967; 97: 331. Link, Google Scholar 9. : Prognosis in patients with carcinoma of the prostate. Cancer1970; 25: 911. Google Scholar 10. : Total perineal prostatectomy for carcinoma of the prostate. J. Urol.1972; 107: 91. Link, Google Scholar 11. : Carcinoma of the prostate: a 15-year followup. J. Urol.1972; 107: 450. Link, Google Scholar 12. : Carcinoma of the prostate: treatment comparisons. J. Urol.1967; 98: 516. Link, Google Scholar 13. : Treatment and survival of patients with cancer of the prostate. Surg. Gynec. 124: 1011. Google Scholar 14. : Estrogen treatment for cancer of the prostate. Early results with 3 doses of diethylstilbestrol and placebo. Cancer1970; 26: 257. Google Scholar © 2002 by American Urological Association, IncFiguresReferencesRelatedDetails Volume 167Issue 2 Part 2February 2002Page: 953-958 Advertisement Copyright & Permissions© 2002 by American Urological Association, IncMetricsAuthor Information Donald F. Gleason More articles by this author George T. Mellinger More articles by this author The Veretans Administration Cooperative Urological Research Group More articles by this author Expand All Advertisement PDF downloadLoading ...