Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ Epidemiology Table Graphic Jump Location|Download (.pdf)|Print Epidemiology Incidence: 159,120 cases Estimated 33,330 deaths (Estimated new cases for 2020 in the United States) Estimated Stage at Presentation Stage I: 50% Stage II: 20% Stage III: 17% Stage IV: 13% Median age: 66 years Siegel R et al. CA Cancer J Clin. 2020;70(1):7–30. Surveillance, Epidemiology and End Results (SEER) Program, available from http://seer.cancer.gov ++ Pathology Table Graphic Jump Location|Download (.pdf)|Print Pathology Adenocarcinoma (acinar): >95% Gleason Score at Presentation Ductal adenocarcinoma✫: <1% (Radical prostatectomy specimens) Mucinous✫: <1% 2–4: 6% Small cell✫: <1% 5–6: 54% Transitional cell✫: <1% 7: 30% Small cell✫: <1% 8–9: 10% ✫Poor prognosis Kantoff PW et al. Prostate Cancer: Principles & Practice. Philadelphia: Lippincott; 2002 ++ Work-up Bone scan if: T1 and PSA >20 T2 and PSA >10 Gleason > or = 8 T3/T4 disease Symptomatic Pelvic CT/MRI if: T3/T4 T1/2 and nomogram indicates probability of LN invasion >10% ++ Staging Table Graphic Jump Location|Download (.pdf)|Print Staging Primary Tumor (T) Clinical T (cT) T Category T Criteria TX Primary tumor cannot be assessed T0 No evidence of primary tumor T1 Clinically inapparent tumor that is not palpable T1a Tumor incidental histologic finding in 5% or less of tissue resected T1b Tumor incidental histologic finding in more than 5% of tissue resected T1c Tumor identified by needle biopsy found in one or both sides, but not palpable T2 Tumor is palpable and confined within prostate T2a Tumor involves one-half of one side or less T2b Tumor involves more than one-half of one side but not both sides T2c Tumor involves both sides T3 Extraprostatic tumor that is not fixed or does not invade adjacent structures T3a Extraprostatic extension (unilateral or bilateral) T3b Tumor invades seminal vesicle(s) T4 Tumor is fixed or invades adjacent structures other than seminal vesicles such as external sphincter, rectum, bladder, levator muscles, and/or pelvic wall Pathological T (pT) T Category T Criteria T2 Organ confined T3 Extraprostatic extension T3a Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck T3b Tumor invades seminal vesicle(s) T4 Tumor is fixed or invades adjacent structures other than seminal vesicles such as external sphincter, rectum, bladder, levator muscles, and/or pelvic wall Note: There is no pathological T1 classification. Note: Positive surgical margin should be indicated by an R1 descriptor, indicating residual microscopic disease. Table Graphic Jump Location|Download (.pdf)|Print Staging Regional Lymph Node (N) N Category N Criteria NX Regional lymph nodes cannot be assessed N0 No positive regional nodes N1 Metastases in regional node(s) Table Graphic Jump Location|Download (.pdf)|Print Staging Distant Metastasis (M) M Category M Criteria M0 No distant metastasis M1 Distant metastasis M1a Nonregional lymph node(s) M1b Bone(s) M1c Other site(s) with or without bone disease Note: When ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.