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Grades and stages of prostate cancer (prostate cancer)
Last reviewed: 07.07.2025
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The most widely used classification of prostate cancer (prostate gland cancer) is Gleason (there are five grades depending on the degree of loss of cell differentiation). The Gleason score is calculated by summing the two most common categories in the preparation, it has an important diagnostic and prognostic value.
Currently, the clinical stage of prostate cancer (prostate cancer) is determined in accordance with the classification proposed by the International Union Against Cancer, sixth edition (2002).
The following stages of prostate cancer (prostate gland cancer) are distinguished:
T1 - incidentally detected tumor (not palpable and not detectable by ultrasound).
- T1a - an incidentally detected tumor (during TUR of the prostate), occupying less than 5% of the resected tissue.
- T1b - an incidentally detected tumor (during TUR of the prostate), occupying more than 5% of the resected tissue.
- T1c - non-palpable prostate tumor detected by TRUS-guided biopsy: indication for biopsy is an increase in PSA levels.
T2 - the tumor is limited to the prostate.
- T2a - the tumor occupies no more than half of one lobe.
- T2b - the tumor occupies more than half of one lobe.
- T2c - the tumor is localized in both lobes.
T3 - the tumor grows beyond the prostate capsule.
- T3a - extracapsular spread of the tumor.
- T3b - extracapsular spread with invasion of the seminal vesicles.
T4 - the tumor is fixed or grows into adjacent organs.
Nx - metastases to regional lymph nodes cannot be assessed.
N0 - no metastases to regional lymph nodes.
N1 - metastases to regional lymph nodes:
Mx - distant metastases cannot be assessed.
M0 - no distant metastases.
M1 - distant metastases.
- M1a - metastases to non-regional lymph nodes.
- Mlb - bone metastases: name bubbles).
- M1c - metastases to other organs (rectum, seminal vesicles).
The extent of the tumor within the prostate and its relation to nearby organs and tissues (category T), the involvement of regional tumor nodes (category N) and the presence of distant metastases (category M) are assessed. When determining the degree of local spread of the process, it is first necessary to determine whether the tumor is limited to the prostate (localized forms of prostate cancer (T1c-T2c) or extends beyond its capsule (T3a-T4b). Regional lymph nodes should be assessed only in cases where this directly affects the treatment tactics - usually when planning radical treatment.
[ Types of prostate cancer:
- small acinar;
- large acinar;
- cribriform;
- papillary;
- solid-trabecular;
- endometrioid;
- glandular cystic;
- mucus-forming.