Zusammenfassung
Bei den verschiedenen therapeutischen Optionen, die heute bei klinisch organbegrenzten Prostatakarzinomen (PCa) zur Verfügung stehen, spielen histopathologische Selektionskriterien eine zunehmende Rolle. Es geht beim Prostatakarzinom nicht nur um die Diagnose, sondern auch um prognostische Informationen für eine stadiengerechte Therapieentscheidung. Neben den klassischen Prognosefaktoren (PSA-Wert, TNM, Gleason-Grad, R-Status), gibt es eine Reihe von neueren Prognosefaktoren (Tumorvolumen, Anteil der Gleason-Grade 4 und 5, zystische Nervenscheideninvasionen, intraduktale Tumorausbreitung) und molekulare Marker, die heute beachtet werden sollten. Die vorliegende Übersicht befasst sich mit den etablierten und neuen Prognosefaktoren sowie den aktuellen Standards der Aufarbeitung und Befundung in der histopathologischen Diagnose des Prostatakarzinoms.
Abstract
Since several therapeutic options are currently available for clinically organ-confined prostate cancer, morphological parameters have rapidly emerged as prognostic factors to stratify patients into different therapeutic modalities. In addition to the PSA value, pathologic stage, as defined by the TNM system, Gleason grade and the surgical margin status, other markers have prognostic implications. This includes the percent pattern 4/5 cancer, tumor volume, intraductal spread, large volume perineural invasion and molecular markers. This review discusses the methods of sampling and reporting in prostate pathology with an emphasis on well established and new prognostic factors.
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Bonkhoff, H. Prognosefaktoren des Prostatakarzinoms. Pathologe 26, 433–443 (2005). https://doi.org/10.1007/s00292-005-0792-z
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DOI: https://doi.org/10.1007/s00292-005-0792-z