Abstract
Stage A prostate cancer refers to tumor that is unsuspected clinically which is incidentally discovered in specimens usually removed for benign prostatic hypertrophy. This situation occurs when either the amount of carcinoma within the gland is small and not detected by rectal examination or when the tumor diffusely infiltrates the gland without resulting in induration or a clinically detected nodule. As one would expect, the biologic behavior of the tumor in these two situations differs considerably. Numerous studies have actually demonstrated that patients with a significant amount of clinically unsuspected prostatic carcinoma tend to be pathologically staged between those patients with clinical B1 and B2 lesions in terms of the incidence of capsular penetration (1), seminal vesicle involvement (1), and pelvic lymph node metastases (1–4).
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References
Oesterling, J.E., Breridler, C.B., Epstein, J.I., Kimball, A.W. and Walsh, P.C. Correlation of clinical stage, serum prostatic acid phosphatase, and preoperative Gleason grade with final pathologic stage in 275 patients with clinically localized adenocarcinoma of the prostate. Submitted for publication.
Donohue, R.E., Mani, J.H., Whitesel, J.A., Mohr, S., Scanavino, D., Augspurger, R.R., Biber, R.J., Fauver, H.E., Wettlaufer, J.N. and Pfister, R.R. Pelvic lymph node dissection: Guide to patient management in clinically locally confined adenocarcinoma of prostate. Urology 20:559–565, 1982.
Golimbu, M., Schinella, R., Morales, P. and Kurusu, S. Differences in pathological characteristics and prognosis of clinical A2 prostatic cancer from A1 and B disease. J. Urol. 119:618–622, 1978.
Smith, J.A., Seaman, J.P., Gleidman, J.B. and Middleton, R.G. Pelvic lymph node metastasis from prostatic cancer: Influence of tumor grade and stage in 452 consecutive patients. J. Urol. 130:290–292, 1983.
Jewett, H.J. The present status of radical prostatectomy for Stages A and B prostatic cancer. Urologic Clinics of North America 2:105–124, 1975.
Blackard, C.E., Mellinger, G.T. and Gleason, D.F. Treatment of Stage 1 carcinoma of the prostate: A preliminary report. J. Urol. 106:729–733, 1971.
Byar, D.P. Survival of patients with incidentally found microscopic cancer of the prostate: Results of a clinical trial of conservative treatment. J. Urol. 108:908–913, 1972.
Greene, L.F. and Simon, H.B. Occult carcinoma of the prostate: Clinical and therapeutic study of eighty-three cases. JAMA 17:1494–1498, 1955.
Nesbit, R.M. and Baum, W.C. Management of occult prostatic carcinoma. J. Urol. 65:890–894, 1951.
Bauer, W.C., McGavran, M.G. and Carlin, M.R. Unsuspected carcinoma of the prostate in suprapubic prostatectomy specimens. Cancer 13:370–378, 1960.
Barnes, R., Hirst, A. and Rosenquist, R. Early carcinoma of the prostate: Comparison of Stages A and B. J. Urol. 115:404–405, 1976.
Correa, R.J., Anderson, R.G., Gibbons, R.P. and Mason, J.T. Latent carcinoma of the prostate - why the controversy? J. Urol. 111:644–646, 1974.
Labess, M. Occult carcinoma in clinically benign hypertrophy ofthe prostate: A pathological and clinical study. J. Urol. 68:893–896, 1952.
Montgomery, T.R., Whitlock, G.F., Nohlgren, J.E. and Lewis, A.M. What becomes of patient with latent or occult carcinoma of the prostate. J. Urol. 86:655–658, 1961.
Khalifa, N.M. and Jarman, W.D. A study of 48 cases of incidental carcinoma of the prostate followed 10 years or longer. J. Urol. 116:329–331, 1976.
Heaney, J.A., Chang, H.C., Daly, J.J. and Prout, G.G.. Prognosis of clinically undiagnosed prostatic carcinoma and the influence of endocrine therapy. J. Urol. 118:283–287, 1977.
Varkarakis, M., Castro, J.E. and Azzopardi, J.G. Prognosis of Stage l carcinoma. Proceedings of the Royal Society of Medicine 63:91–97, 1970.
Murphy, W.M., Dean, P.J., Brasfield, J.A, and Tatum, L. Incidental carcinoma of the prostate: How much sampling is adequate. Am. J. Surg. Pathol. 10:170–174, 1986.
Newman, A.J., Graham, M.A., Carlton, C.E. and Lehman, S. Incidental carcinoma of the prostate at the time of transurethral resection: Importance of evaluating every chip. J. Urol. 128:948–950, 1982.
Schevchuk, M.M., Tannenbaum, S. and Tannenbaum, M. Incidence of occult prostatic carcinoma in surgical specimens. (Abstract) Lab. Invest. 50:54A, 1984.
Munsie, W.J. and Foster, E.A. Unsuspected very small foci of carcinoma of the prostate in transurethral resection specimens. Cancer 21:692–698, 1968.
Benyon, L.L., Busuttil, A., Newsam, J.E. and Chisholm, G.D. Incidental carcinoma of the prostate: Selection for deferred treatment. Br. J. Urol. 55:733–736, 1983.
Parfitt, H.E., Smith, J.A., Gliedman, J.B. and Middleton, R.G. Accuracy of staging in A1 carcinoma of the prostate. Cancer 51:2346–2350, 1983.
Sonda, L.P., Grossman, H.B., Maregor, R.J. and Gikas, P.W. Incidental adenocarcinoma of the prostate: The role of repeat transurethral resection in staging. The Prostate 5:141–146, 1984.
Cantrell, B.B., Dlerk, D.P., Eggleston, J.C., Boitnott, J.K. and Walsh, P.C. Pathological factors that influence prognosis in Stage A prostatic cancer: The influence of extent versus grade. J. Urol. 125:516–520, 1981.
Bridges. C.H., Belville, W.D., Insalaco, S.J. and Buck, A.S. Stage A prostatic carcinoma and repeat transurethral resection: A reappraisal 5 years later. J. Urol. 129:307–308, 1983.
Carroll, P.R., Leitner, T.C., Yen, T.S.B., Watson, R.A. and Williams, R.D. Incidental carcinoma of the prostate: Significance of staging transurethral resection. J. Urol. 133:811–814, 1985.
Ford, T.F., Cameron, K.M., Parkinson, M.C. and O’Donaghue, E.P.N. Incidental carcinoma of the prostate: Treatment selection by second-look TURP. Br. J. Urol. 56:682–686, 1984.
Epstein, J.I., Paull, G., Eggleston, J.C. and Walsh, P.C. Prognosis of untreated Stage A1 prostate carcinoma: A study of 94 cases with extended follow-up. J. Urol. 136:837–839, 1986.
Blute, M.L., Zincke, H. and Farrow, G.M. Long-term follow-up of young patients with Stage A adenocarcinoma of the prostate. J. Urol. 136:840–843, 1986.
Epstein, J.I., Oesterling, J.E. and Walsh, P.C. The volume and anatomical location of residual tumor in radical prostatectomy specimens removed for Stage A1 prostate cancer. J. Urol., 1988.
McNeal, J.E, and Bostwick, D.G. Intraductal dysplasia: A premalignant lesion of the prostate. Hum. Pathol. 17:64, 1986.
McMillen, S.M. and Wettlaufer, J.S. The role of repeat transurethral biopsy in Stage A carcinoma of the prostate. J. Urol. 116:759–760, 1976.
Moore, R.A. The morphology of small prostatic carcinoma. J. Urol. 33:224, 1935.
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© 1988 Plenum Press, New York
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Epstein, J.I., Walsh, P.C. (1988). The Classification and Prognosis of Untreated Stage A1 and A2 Prostate Cancer with a Comparison of their Histologic Findings at Radical Prostatectomy. In: Coffey, D.S., Resnick, M.I., Dorr, F.A., Karr, J.P. (eds) A Multidisciplinary Analysis of Controversies in the Management of Prostate Cancer. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1667-1_6
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DOI: https://doi.org/10.1007/978-1-4613-1667-1_6
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