1988 Volume 79 Issue 7 Pages 1193-1201
A trial to elucidate the linkage between occult and manifest carcinomas of the prostate was done. It was hypothesized that the progression of prostatic carcinoma might be explained by the factors of time, histological grade and tumor volume. The subjects were 20 cases of stage A, 35 cass of stage B, 46 cases of stage C and 114 cases of stage D prostate carcinomas. (1) Analysis of the clinical and pathological findings of stage A carcinoma revealed that there was no death in stage Al cases but 46 percent of stage A2 cass died of prostatic cancer. This implies that although stage A is occult carcinoma, stages Al and A2 should be definitely separated as clinical entities. Stage Al has much possibility to remain as occult carcinoma but stage A2 has strong possibility to progress to a manifest cancer. (2) In the manifest carcinoma cases, histological grade between the group of long survivor and the group of early cancer death was evaluated.
Long survivors had a higher proportion of well differentiated adenocarcinoma, while the group of early cancer death had a strong tendency to be composed of poorly differentiated adenocarcinoma. Even in the group of long survivor, with the progression of clinical stage, the percentage of well differentiated adenocarcinoma decreased. (3) Two groups with and without metastasis at first admission were analyzed concerning the tumor volume which was expressed by T stage. The former group had a tendency to be larger in clinical T classification and poorer in histological grade differentiation. As a conclusion, an increase of tumor volume and an increase of the ratio of poorly differentiated adenocarcinoma in the whole tumor are thought to be most important for progression from occlut to manifest carcinoma.
