Cytologic Malignancy Grading of Prostatic Carcinoma by Transrectal Aspiration Biopsy:A Five-year Follow-up Study of 469 Hormone-treated Patients

In 469 patients with prostatic carcinoma diagnosed by transrectal aspiration biopsy, the tumours were cytologically graded according to cell differentiation. The classification was grade I (highly differentiated) in 131 patients, grade II (moderately differentiated) in 265 and grade III (poorly differentiated) in 73 patients.Five-year follow-up was possible in all 469 patients. All received hormonal therapy (oestrogens and/or bilateral orchiectomy). Most of the highly differentiated carcinomas responded well to treatment, but most of the poorly differentiated tumours did not respond.Comparisons between differentiation grades and crude survival rates showed that 73% of the patients with highly differentiated tumours, 61% of those with moderately differentiated tumours and 29% with poorly differentiated tumours were still alive after 3 years. The corresponding percentages after 5 years were 68, 55 and 11.The importance of malignancy grading of prostatic carcinoma prior to commencing treatment is emphasized.