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.
KeywordsProstate Cancer Radical Prostatectomy Gleason Score Urinary Tract Obstruction Seminal Vesicle Invasion
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