Staging of prostate cancer

Liang Cheng, Rodolfo Montironi, David G. Bostwick, Antonio Lopez-Beltran, Daniel M. Berney

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Prostatic carcinoma (PCa) is a significant cause of cancer morbidity and mortality worldwide. Accurate staging is critical for prognosis assessment and treatment planning for PCa. Despite the large volume of clinical activity and research, the challenge to define the most appropriate and clinically relevant staging system remains. The pathologically complex and uncertain clinical course of prostate cancer further complicates the design of staging classification and a substaging system suitable for individualized care. This review will focus on recent progress and controversial issues related to prostate cancer staging. The 2010 revision of the American Joint Committee on Cancer/Union Internationale Contre le Cancer (AJCC/UICC) tumour, node and metastasis (TNM) system is the most widely used staging system at this time. Despite general acceptance of the system as a whole, there is controversy and uncertainty about its application, particularly for T2 subclassification. The three-tiered T2 classification system for organ-confined prostate cancer is superfluous, considering the biology and anatomy of PCa. A tumour size-based substaging system may be considered in the future TNM subclassification of pT2 cancer. Lymph node status is one of the most important prognostic factors for prostate cancer. Nevertheless, clinical outcomes in patients with positive lymph nodes are variable. Identification of patients at the greatest risk of systemic progression helps in the selection of appropriate therapy. The data suggest that the inherent aggressiveness of metastatic prostate cancer is closely linked to the tumour volume of lymph node metastasis. We recommend that a future TNM staging system should consider subclassification of node-positive cancer on the basis of nodal cancer volume, using the diameter of the largest nodal metastasis and/or the number of positive nodes.

Original languageEnglish
Pages (from-to)87-117
Number of pages31
JournalHistopathology
Volume60
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Prostatic Neoplasms
Neoplasms
Neoplasm Metastasis
Lymph Nodes
Carcinoma
Neoplasm Staging
Tumor Burden
Reoperation
Uncertainty
Anatomy
Morbidity
Mortality
Therapeutics
Research

Keywords

  • Metastasis
  • Multifocality
  • Neoplasia
  • Nodal classification
  • Prognosis
  • Prostate
  • Prostatic adenocarcinoma
  • Specimen handling and reporting
  • Tumour, node and metastasis/American Joint Committee on Cancer staging

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

Cite this

Cheng, L., Montironi, R., Bostwick, D. G., Lopez-Beltran, A., & Berney, D. M. (2012). Staging of prostate cancer. Histopathology, 60(1), 87-117. https://doi.org/10.1111/j.1365-2559.2011.04025.x

Staging of prostate cancer. / Cheng, Liang; Montironi, Rodolfo; Bostwick, David G.; Lopez-Beltran, Antonio; Berney, Daniel M.

In: Histopathology, Vol. 60, No. 1, 01.2012, p. 87-117.

Research output: Contribution to journalArticle

Cheng, L, Montironi, R, Bostwick, DG, Lopez-Beltran, A & Berney, DM 2012, 'Staging of prostate cancer', Histopathology, vol. 60, no. 1, pp. 87-117. https://doi.org/10.1111/j.1365-2559.2011.04025.x
Cheng L, Montironi R, Bostwick DG, Lopez-Beltran A, Berney DM. Staging of prostate cancer. Histopathology. 2012 Jan;60(1):87-117. https://doi.org/10.1111/j.1365-2559.2011.04025.x
Cheng, Liang ; Montironi, Rodolfo ; Bostwick, David G. ; Lopez-Beltran, Antonio ; Berney, Daniel M. / Staging of prostate cancer. In: Histopathology. 2012 ; Vol. 60, No. 1. pp. 87-117.
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