Summary
The staging and grading results of 107 patients considered to be potential candidates for radical prostatectomy are described. In all patients lymph node status was proven histologically. Understaging of the local tumor was found in 51.4% of the patients. Local overstaging in clinical T3 patients was noted in 23%. Undergrading of the pre-operative biopsy specimen was noted in 42% of the patients, while overgrading occurred in 6% of the patients. False negative frozen sections of pelvic lymph nodes occurred in 7%. The percentage of false negative frozen sections was higher in higher T-categories and higher tumor grades. The presence of lymph node metastases is a function of T-category and tumor grade. In T3G3 patients positive nodes were found in 90% of the cases. Bipedal lymphangiography and CT-scanning were of no value in detecting lymph node metastases in patients not being T3 or G3. In clinical T3 patients total tumor removal, as defined by negative pelvic lymph nodes and negative margins of resection, could be achieved in 30% of the cases.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Belt E, Schröder FH (1972) Total perineal prostatectomy for carcinoma of the prostate. J Urol 107:91
Bosch RJLH, Kurth KH, Schröder FH (1986) Surgical treatment of locally advanced (T3) prostatic carcinoma — early results. Paper presented at the 81st AUA ann meet, New York, abstr no 576
Byar DP, Mostofi FK (1972) Carcinoma of the prostate — prognostic evaluation of certain pathological features in 208 radical prostatectomies. Examined by step-section technique. Cancer 30:5
Catalona WJ, Stein AJ (1982) Staging errors in clinically localized prostatic cancer. J Urol 127:452
Catalona WJ, Stein AJ (1982) Accuracy of frozen section detection of lymph node metastases in prostatic carcinoma. J Urol 127:460
Catalona WJ, Dresner SM (1985) Nerve-sparing radical prostatectomy. Extraprostatic tumor extension and preservation of sexual function. J Urol 134:1149
Donohue RE, Mani JH, Whitesel JA, Mohr S, Scanavino D, Augspurger RR, Biber RJ, Fauver HE, Wettlaufer JN, Pfister RR (1982) Pelvic lymph node dissection. Guide to patient management in clinically locally confined adenocarcinoma of the prostate. Urology 20:559
Eggleston JC, Walsh PC (1985) Radical prostatectomy with preservation of sexual function: Pathological findings in the first 100 cases. J Urol 134:1146
Elder JS, Catalona WJ (1984) Management of newly diagnosed metastatic carcinoma of the prostate. Urol Clin N Am 11:283
Fair WR, Kadmon D (1983) Carcinoma of the prostate: diagnosis and staging. Current status and future prospects. World J Urol 1:3
Fowler JE, Torgerson L, McLeod DG, Stutzman RE (1981) Radical prostatectomy with pelvic lymphadenectomy: observations on the accuracy of staging with lymph node frozen sections. J Urol 126:618
Golimbu M, Morales P, Al Askari S, Shulman Y (1981) Cat scanning in staging of prostatic cancer. Urology 18:305
Grossman IC, Carpiniello V, Greenberg SH, Malloy TR, Wein AJ (1980) Staging pelvic lymphadenectomy for carcinoma of the prostate: review of 91 cases. J Urol 124:632
Hoekstra WJ, Schroeder FH (1981) The role of lymphangiography in staging of prostatic cancer. Prostate 2:433
Kidd R, Correa RJ Jr (1984) Fine needle aspiration biopsy of lymphangiographically normal lymph nodes: a negative view. AJR 142:1005
Kidd R, Crade RD, Dail DH (1984) Lymphangiography and fine needle aspiration biopsy: ineffective for staging early prostate cancer. AJR 142:1007
Lange PH, Narayan P (1983) Understaging and undergrading of prostatic cancer: argument of postoperative radiation as adjuvant therapy. Urology 21:113
Lieskovsky G, Skinner DG, Weisenburger T (1980) Pelvic lymphadenectomy in the management of carcinoma of the prostate. J Urol 124:635
McCullough DL, McLaughlin AP, Gittes RF (1977) Morbidity of pelvic lymphadenectomy and radical prostatectomy for prostatic cancer. J Urol 117:206
Middleton AW Jr (1981) Pelvic lymphadenectomy with modified radical retropubic prostatectomy as a single operation: technique used and result in 50 consecutive cases. J Urol 125:353
Mostofi FK (1975) Grading of prostatic carcinoma. Cancer Chemother Rep 59:111
Olsson CA (1985) Staging lymphadenectomy should be an antecedent to treatment in localized prostatic carcinoma. Urology [Suppl to vol 25] 2:4
Sadlowski RW, Donohue DJ, Richman AV, Sharpe JR, Finney RP (1983) Accuracy of frozen section diagnosis in pelvic lymph node staging biopsies for adenocarcinoma of the prostate. J Urol 129:324
Sawczuk IS, de Vere White R, Palmer Gold R, Olsson CA (1983) Sensitivity of computed tomography in evaluation of pelvic lymph node metastases from carcinoma of bladder and prostate. Urology 21:81
Smith JA, Seaman JP, Gleidman JB, Middleton RG (1983) Pelvic lymph node metastases from prostatic cancer: influence of tumor grade and stage in 452 consecutive patients. J Urol 130:290
UICC (1978) T.N.M. classification of malignant tumors, Geneva
Vecchio Th J (1966) Predictive value of a single diagnostic test in unselected populations. N Engl J Med 274:1171
Whitmore WF Jr (1984) Natural history and staging of prostate cancer. Urol Clin N Am 11:205
Zincke H, Utz DC, Benson RC, Patterson DE (1984) Bilateral pelvic lymphadenectomy and radical retropubic prostatectomy for stage C adenocarcinoma of prostate. Urology 24:532
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bosch, R.J.L.H., Schroeder, F.H. Current problems in staging and grading prostatic carcinoma with special reference to T3 carcinoma of the prostate. World J Urol 4, 141–146 (1986). https://doi.org/10.1007/BF00327010
Issue Date:
DOI: https://doi.org/10.1007/BF00327010