American Staging for Prostate Cancer
History:
American or AUS (American Urologic System) Staging has been
translated to TNM extent of disease notation by the American
Joint Committee.
Criteria:
Pathologic staging with some clinical guidelines.
Categories:
| A |
Stage A can be subdivided based
on the number of cell clusters (foci) seen on microscopic
examination. |
| B |
The difference between Stage
A and Stage B is whether nodule(s) are clinically palpable
(or visibly seen) in prostate. |
| C |
Dividing line between Stage
B and Stage C is capsular invasion microscopically. |
| D |
Stage D is metastatic disease
identified either clinically or microscopically. |
In AJCC staging, lymph nodes in N notation range from single
homolateral to fixed regional and distant. These are all equivalent
to Stage D disease.
Guidelines for American Staging for Prostate:
- Stages A1, B1, C1, D1 correspond to T1, T2, T3, T4.
- Stages A and B are localized, Stage C regionalized, Stage
D distant.
Gleason's Score/system for Grading of Prostate Cancer
History:
First proposed in 1966 by Donald F. Gleason, a pathologist
at the University of Minnesota in Minneapolis, MN.
Criteria:
A pathologic classification only. Based on the premise that
poorly-differentiated tumors are more aggressive and unpredictable
than well-differentiated tumors. Gleason's score is not a
staging system.
Method:
- Pathologist reviews specimen microscopically and observes
whether the malignant cells are similar in structure to
the tissue of origin. The closer to the original tissue,
the better differentiated.
- Pathologist looks for a primary predominant pattern for
cells, and a secondary or lesser pattern. Each is given
a score from 1 to 5.
- Scores for primary and secondary patterns are added together
to achieve the Gleason score for the tumor. Scores can range
from 2 (uniformly well differentiated 1 + 1) to 10 (diffusely
anaplastic 5 + 5)
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