Histologic differentiation, cancer volume, and pelvic lymph node metastasis in adenocarcinoma of the prostate

Cancer. 1990 Sep 15;66(6):1225-33. doi: 10.1002/1097-0142(19900915)66:6<1225::aid-cncr2820660624>3.0.co;2-x.


The Gleason grading system for prostate cancer was applied quantitatively to analysis of entire tumors in 209 radical prostatectomy specimens from patients with clinical Stage A and Stage B carcinoma. Percentage of poorly differentiated tumor (Gleason histologic pattern 4 and/or 5) was related to quantitated cancer volume, cancer location within the prostate, and presence or absence of pelvic lymph node metastasis. A strong correlation was found between cancer volume, percentage of poorly differentiated cancer, and nodal metastasis. Twenty-two of 38 patients with more than 3.2 cc of Gleason histologic pattern 4-5 cancer had nodes with positive results, compared with one of 171 patients with less than 3.2 cc of pattern 4-5 cancer. Gleason histologic patterns 1 and 2 cancer was found mainly in a small subgroup of tumors whose site of origin was in the anatomic transition zone and whose volume was less than 1 cc. Gleason "cribriform" histologic pattern 3 cancer was thought to represent mainly intraductal carcinoma. Its increase in area with increasing cancer volume paralleled the increase in pattern 4 cancer and was counter to the decrease in other types of pattern 3 cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Carcinoma / pathology
  • Cell Nucleus / ultrastructure
  • Cytoplasm / ultrastructure
  • Humans
  • Lymphatic Metastasis*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Pelvis
  • Prostate / pathology
  • Prostatic Neoplasms / pathology*
  • Regression Analysis