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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical staging is the attempt to determine the pathologic extent of a cancer by clinical tests (Whitmore). Traditionally, staging of prostate cancer has relied on the digital rectal examination, but ultrasonography, which provides an unprecedented picture of the gland, has become a valuable adjunct. The overall sonographic pattern helps to classify a tumor as "localized" or "extensive." A more detailed analysis yields information about the volume and location of the primary tumor; the presence, location, and extent of extracapsular extension; and the presence of seminal vesicle invasion. Comparison of sonograms with corresponding sections of radical prostatectomy specimens demonstrates that ultrasound complements the digital examination in determining by clinical tests the pathologic extent of a cancer.
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PMID:Staging of prostate cancer. Value of ultrasonography. 268 1

Although multiple studies have addressed the prognostic importance of tumor differentiation in patients with clinically localized prostate cancer, few data are available in patients with metastatic disease. We evaluated and compared survival data in two groups of men with Whitmore stage D2 metastatic prostate cancer initially treated with hormonal therapy. A series of 76 patients with D2 metastatic disease were evaluated and treated at the National Cancer Institute (NCI) in conjunction with an additional cohort of 141 patients from the Louisiana State University School of Medicine (LSU). Pathological specimens were classified according to the Gleason score. Fifty-two (25%) of the combined NCI/LSU specimens had a Gleason score of 6 or less, 71 (34%) had a value of 7, and remaining 87 (41%) had scores between 8 and 10. The median PSA at the time of diagnosis for the NCI patients was 294.2 ng/ml. Time to treatment failure was defined as the time that a greater than 50% increase above nadir PSA was noted. In neither group was Gleason score correlated with overall survival. There was no association between the time to progression following hormone therapy and primary tumor Gleason score. The PSA concentration at the time of diagnosis was not correlated with the Gleason score for the NCI patients; however, there was an inverse correlation between pretreatment PSA level and time to progression following hormonal ablation. Gleason score does not appear to impact survival in metastatic prostate cancer. PSA as a marker of the biological behavior in metastatic disease may also be limited. These findings should be reevaluated in larger, better matched cohorts. Novel techniques such as serum proteomics, microarrays, and metastatic cell isolation methods may better predict outcome in advanced prostate cancer.
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PMID:Gleason score and pretreatment prostate-specific antigen in survival among patients with stage D2 prostate cancer. 1559 75