A TRIAL STUDY OF STAGING A₁ AND A₂ INCIDENTAL PROSTATIC CARCINOMA BY TISSUE OBTAINED BY TRANSURETHRAL RESECTION

Abstract

During the period between July, 1971 and April, 1985, 1428 transurethral resection of the prostate (TUR-P) for clinically benign diseases were done at the kitasato University Hospital. Sixty-seven cases of incidental (stage A) carcinoma were found with an incidence of 4.7per cent. For the purpose of this study, we tried to classify between stage A₁ and stage A₂ prostatic carcinoma from TUR-P specimens, according to the current literature and the expected outcome of our study that were derived from the number of tumor tips and the degree of differentiation. For each patient. 3.6 slides, 16.4 tissue chips/slide and 59 mean tissue chips/patient (26-240 tissue chips/patient) were examined microscopically. The survival rates of patients with well, moderately and porly differentiated tumors were 76, 61 and 28per cent, respectively, at 10 years. The survival rates at 10 years of Gleason pattern groups 2 to 4, 5 to 7 and 8 to 10 were 88, 54 and 29 per cent, respectively. The survival rates of patients with 1, 2 or less 3 or less, 4 or less, 5 or less and 6 or less tumor chips were 77, 84, 80, 79, 79 and 80 per cent respectively, at 10 years. Three tumor chips and 6 tumor chips were found at 5.01 and 10.1 per cent, respectively, in 59 examined chips.
The survival rates at 5 and 10 years with well differentiated and 3 or less tumor chips group were 90 and 90per cent, respectively. We proposed as a preliminary classification:
stage A₁: well differentiated (or Gleason pattern sum 2 to 4) and tumor chips≤5% of examined specimen
stage A₂: anything other than stage A₁
Our classification system was derived from a limited number of the prostatic carcinoma cases. More refined and precise staging system in incidental prostatic carcinoma at TUR-P should be produced from a large number of series.