Prostate carcinoma is staged with the AJCC TNM classification with several added factors.
The spread of cancer within and beyond the cancer defines the T stage
- T1 disease is asymptomatic and clinically undetectable and found on biopsy of the prostate (either TURP specimen or transrectal ultrasound biopsy)
- T2 disease is located within the prostate but does not penetrate the prostate capsule.
- T3 disease extends through the capsule (T3a) or into seminal glands (T3b)
- T4 disease extends into extraprostatic structures such as the bladder or rectum.
Distant Metastatic Disease
Metastatic disease is the most important indicator of prognosis.
- M0 disease has no distant metastatic disease
- M1 disease has distant metastates present
The Gleason Score (described above) is another prognostic factor used in staging of prostate cancer.
- Gleason scores of 6 or less are low risk
- Gleason scores of 7 are intermediate risk
- Gleason scores of 8 and above denotes a high risk
The PSA level is another important prognostic factor.
- PSA < 10 is associated with a low risk
- PSA of 10 - 20 is intermediate risk
- PSA of > 20 is high risk disease