What is the clinical significance of prostate cancer incidentally discovered in tissue removed to relieve urinary tract obstruction mostly by transurethral resection (stage T1a and T1b cancers)?


The concept of stage T1a and T1b (stage A) cancers applies to the prostatic adenocarcinoma discovered incidentally in a specimen removed by transurethral resection of the prostate (TURP). Stage T1a (stage A1) is defined as prostate cancer with a tumor volume ≤5% of tissue chips. Stage T1b (stage A2) cancer is defined as prostate cancer present in TURP specimens with a Gleason score ≥7 and/or tumor volume greater than 5%. Stage T1a prostate cancer may not require special treatment as it is considered indolent, whereas T1b prostate cancer requires standard treatment for prostate cancer as it is often associated with cancer in other parts of the prostate. Stage T1c prostate cancer is defined as cancer diagnosed by needle core biopsy. Therefore, in a pathology report of a TURP specimen, the pathologist should include the Gleason score and percentage of tumor involvement if present. In addition, we recommend specifying T1a or T1b in the pathology diagnosis.


Prostate Cancer Radical Prostatectomy Gleason Score Urinary Tract Obstruction Seminal Vesicle Invasion 


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  1. 1.
    Cantrell BB, Deklerk DP, Eggleston JC, Boitnett JK, Walsh PC (1981) Pathological factors that influence prognosis in stage A prostatic cancer: the influence of extent versus grade. J Urol 125:516–520.PubMedGoogle Scholar
  2. 2.
    Correa RJ Jr, Anderson RJ, Gibbons RP, Mason JT (1974) Latent carcinoma of the prostate: why the controversy? J Urol 111:644–646.PubMedGoogle Scholar
  3. 3.
    Jewett HJ (1975) The present status of radical prostatectomy for stage A and B prostatic cancer. Urol Clin North Am 2:105–124.PubMedGoogle Scholar
  4. 4.
    Greene DR, Egawa S, Neerhut G, Flanagan W, Wheeler TM, Scardino PT (1991) The distribution of residual cancer in radical prostatectomy specimens in stage A prostate cancer. J Urol 145:324–329.PubMedGoogle Scholar
  5. 5.
    Larsen MP, Ballentine H, Epstein JI (1991) Can stage A1 tumor extent be predicted by transurethral resection tumor volume percent or grade? A study of 64 stage A1 radical prostatectomies with comparison to prostates removed for stage A2 and B disease. J Urol 146:1059–1063.PubMedGoogle Scholar
  6. 6.
    Epstein JI, Oesterling JE, Walsh PC (1988) Tumor volume versus percent involved by tumor correlated with progression of stage A prostate cancer. J Urol 129:980–984.Google Scholar
  7. 7.
    Zincke H, Blute ML, Fallen MJ, Farrow GM (1991) Radical prostatectomy for stage A adenocarcinoma of the prostate: staging errors and their implications for treatment recommendations and disease outcome. J Urol 146:1053–1058.PubMedGoogle Scholar
  8. 8.
    Christensen WN, Partin AW, Walsh PC, Epstein JI (1990) Pathologic findings in clinical stage A2 prostate cancer: relation of tumor volume, grade, and locations to pathologic stage. Cancer 65:1021–1027.PubMedCrossRefGoogle Scholar
  9. 9.
    Stamey TA, McNeal JE, Freiha FS, Redwine E (1988) Morphometric and clinical studies on 68 consecutive radical prostatectomies. J Urol 139:1235–1241.PubMedGoogle Scholar
  10. 10.
    Greene DR, Wheeler TM, Egawa S, Dunn JK, Scardino PT (1991) A comparison of the morphological features of cancer arising in the transition zone and in the peripheral zone of the prostate. J Urol 146:1069–1076.PubMedGoogle Scholar
  11. 11.
    Epstein JI, Cho KR, Quinn BD (1990) Relationship of severe dysplasia to stage A (incidental) adenocarcinoma of the prostate. Cancer 65:2321–2327.PubMedCrossRefGoogle Scholar
  12. 12.
    Quinn BD, Cho KR, Epstein JI (1990) Relationship of severe dysplasia to stage B adenocarcinoma of the prostate. Cancer 65:2328–2337.PubMedCrossRefGoogle Scholar
  13. 13.
    McNeal JE, Redwine EA, Freiha ES, Stamey TA (1988) Zonal distribution of prostate adenocarcinoma: correlation with histologic pattern and distribution of spread. Am J Surg Pathol 12:897–906.PubMedCrossRefGoogle Scholar
  14. 14.
    Kabalin JN, McNeal JE, Price HM, Freiha FS, Stamey TA (1989) Unsuspected adenocarcinoma of the prostate in patients undergoing cystoprostatectomy for other causes: incidence, histology, and morphometric observations. J Urol 141:1091–1094.PubMedGoogle Scholar

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