Carcinoma of the Prostate Gland: A Pathologic Study

Kahler, James E.

doi:10.1016/s0022-5347(17)71690-4

Cited by 122 publications

(10 citation statements)

References 10 publications

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“…The frequency of distant metastasis was about three times as high in the poorly differentiated tumours as in moderately or highly differentiated tumours. This agrees with previous work on cytologic grading in tissue sections (Kahler, 1939;Vickery & Kerr, 1963).…”

Section: Scand J Urol Nephrol5supporting

confidence: 92%

“…They are based exclusively on the degree of cellular atypia in the sections. In 189 prostatic carcinomas examined post rnortem, Kahler (1939) found that 19 % were grade I, 50 % grade 11, 27.5 % grade I11 and 3.5% grade IV. The incidence of distant metastasis was increased in the higher degrees of malignancy.…”

Section: Discussionmentioning

confidence: 97%

“…Of the writers who stress the importance of cytologic details in tissue specimens, some (Kahler, 1939;Thompson, 1942;Pool & Thompson, 1956) have used the criteria proposed by Broders (1 922) for epitheliomas of the genito-urinary organs. Four grades of malignancy in ascending order from I to IV are recognized.…”

Section: Discussionmentioning

confidence: 99%

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Cytologic Malignancy Grading of Prostatic Carcinoma by Transrectal Aspiration Biopsy:A Five-year Follow-up Study of 469 Hormone-treated Patients

1971

Scandinavian Journal of Urology and Nephrology

201

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In 469 patients with prostatic carcinoma diagnosed by transrectal aspiration biopsy, the tumours were cytologically graded according to cell differentiation. The classification was grade I (highly differentiated) in 131 patients, grade I1 (moderately differentiated) in 265 and grade I11 (poorly differentiated) in 73 patients.Five-year follow-up was possible in all 469 patients. All received hormonal therapy (oestrogens and/or bilateral orchiectomy). Most of the highly differentiated carcinomas responded well to treatment, but most of the poorly differentiated tumours did not respond.Comparisons between differentiation grades and crude survival rates showed that 73% of the patients with highly differentiated tumours, 61% of those with moderately differentiated tumours and 29 % with poorly differentiated tumours were still alive after 3 years. The corresponding percentages after 5 years were 68, 55 and 11.The importance of malignancy grading of prostatic carcinoma prior to commencing treatment is emphasized. Scand J Urol Nephrol 5Scand J Urol Nephrol Downloaded from informahealthcare.com by McMaster University on 12/09/14For personal use only. -1966. Cytologic diagnosis of prostatic tumours with 299-303. Scand J Urol Nephrol Downloaded from informahealthcare.com by McMaster University on 12/09/14 For personal use only. 229-235. 75 1-756. 1119-1 132. Scand J Urol Nephrol5Scand J Urol Nephrol Downloaded from informahealthcare.com by McMaster University on 12/09/14For personal use only.

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Section: Scand J Urol Nephrol5supporting

confidence: 92%

Section: Discussionmentioning

confidence: 97%

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Cytologic Malignancy Grading of Prostatic Carcinoma by Transrectal Aspiration Biopsy:A Five-year Follow-up Study of 469 Hormone-treated Patients

1971

Scandinavian Journal of Urology and Nephrology

201

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“…On the other hand, many grading systems used showed low reproducibility or were not tested for it, which caused some authors to deny its applicability [17,42,70]. Several studies, however, did find correlations between grade and survival [24,36,41,57,66], grade and metastases [10,22,67,71] and grade and tumor invasion [14] (see Table 1). These findings suggested that grading can be useful to assess tumor malignancy, provided that it is applied accurately.…”

Section: Grading Of Prostate Adenocarcinomamentioning

confidence: 99%

Image analysis and grading of prostate adenocarcinoma

1991

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The multitude of grading systems proposed for prostate adenocarcinoma illustrate the putative value of tumor grading as a predictor of prognosis. However, it also indicates the uncertainty and subjectivity of visual grading, as is confirmed by the results of several studies. Recent computer techniques enable fast image processing of microscoping images. Hence, a quantitative assessment of cellular and nuclear features can be obtained, eliminating subjectivity of visual grading. DNA-analysis and morphometric karyometry can be valuable for predicting prognosis in prostate tumors. For routine use, however, standardized preparatory techniques are mandatory. Up till now image analysis of microscopic images is a useful tool in addition to visual grading. Further standardization, inter-as well as intra-laboratory, is necessary to elaborate its value as a reproducible tool in tumor grading.Ever since Broders (1925) [15] introduced the grading of tumors on base of cytological and histological features, practically all tumors have been submitted to different grading systems to be used as predictors of tumor behavior. Many of the proposed grading systems, however, did not offer the desired accuracy in predicting malignant tumor behavior. Moreover, reproducibility of the grading systems in general is rather poor, since the criteria are often loosely defined and can be interpreted in many ways. On the other hand, benign or less malignant lesions can contain small malignant parts that can be overlooked. This heterogeneity is present in many tumors. Renal cell carcinoma is especially known for its multiple cell populations, and for this reason grading systems for renal cell carcinoma are also of doubtful value.Transitional cell carcinomas of the urinary tract are described by only a limited number of grading systems that are very similar in their description of malignancy. Prostate adenocarcinoma is the tumor of the urogenital tract for which a far greater number of grading systems has been proposed than for other urological tumors. The variety and large number of grading systems for prostate cancer caused us to select this type of tumor for further discussion. First, the five most widely used visual grading systems are reviewed. Second, the grading systems using image analysis parameters are discussed.Since no single tumor marker has so far allowed optimal prediction of tumor behavior, the fact that both visual grading and quantitative pathology have mutual interests means that they need to be applied in concert. Image analytical findings should merely be used in addition to pathological grading rather than as a completely different entity. When staining and computer techniques progress, the use of quantitative techniques will become more and more integrated into routine clinical pathology. Grading of prostate adenocarcinomaThe first grading system for prostate adenocarcinoma was introduced by Broders in 1925 [15] and was based on the estimated percentage of glandular differentiation. Many grading systems did not show signific...

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“…Whereas mortality records show an average annual death-rate in Great Britain of approximately 12 per 100,0oo male population, dctailed studies of unselected post-mortem material support a far greater frequency for the condition. Foci of malignant cells indistinguishable from those occurring in the active disease and ranging from minute to macroscopic size are known to exist in much higher and increasing proportion among elderly male subjects (Muir, 1934;Moore, 1935;Rich, 1935;Gaynor, 1938;Kahler, 1939;Baron and Angrist, 1941;Vernet, 1944;Andrews, 1949;Edwards, Steinthorsson, and Nicholson, 1953;Franks, 1954;Hirst and Rergman, 1954).…”

Section: The Doubtfully Malignant Prostate By J D Fergusson Londonmentioning

confidence: 99%

The doubtfully malignant prostate

Fergusson¹

1965

Journal of British Surgery

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Carcinoma of the Prostate Gland: A Pathologic Study

Cited by 122 publications

References 10 publications

Cytologic Malignancy Grading of Prostatic Carcinoma by Transrectal Aspiration Biopsy:A Five-year Follow-up Study of 469 Hormone-treated Patients

Cytologic Malignancy Grading of Prostatic Carcinoma by Transrectal Aspiration Biopsy:A Five-year Follow-up Study of 469 Hormone-treated Patients

Image analysis and grading of prostate adenocarcinoma

The doubtfully malignant prostate

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