Prostate Cancer Flashcards
Prostate T Staging
Tx Primary tumour cannot be assessed
T0 No evidence of primary tumour
T1* Clinically inapparent tumour not palpable or visible by imaging
T1a* Tumour incidental histological finding in 5% or less of tissue resected
T1b* Tumour incidental histological finding in more than 5% of tissue resected
T1c* Tumour identified by needle biopsy (e.g. because of elevated PSA)**
T2 Tumour confined within prostate
T2a Tumour involves one half of one lobe or less
T2b Tumour involves more than half of one lobe, but not both lobes
T2c Tumour involves both lobes
T3 Tumour extends through the prostate capsule***
T3a Extraprostatic extension (unilateral or bilateral) including microscopic bladder neck involvement
T3b Tumour invades seminal vesicle(s)
T4 Tumour is fixed or invades adjacent structures other than seminal vesicles external sphincter, rectum, levator muscles or pelvic wall
Prostate N Staging
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Regional lymph node metastasis
Prostate M Staging
M0 No distant metastasis M1 Distant metastasis M1a Non-regional lymph node(s) M1b Bone(s) M1c Other site(s)
Prostate Stage 1 Grouping
Stage I T1, T2a N0 M0
Prostate Stage 2 Grouping
Stage II T2b, T2c N0 M0
Prostate Stage 3 Grouping
Stage III T3, T4 N0 M0
Prostate Stage 4 Grouping
Stage IV Any T
Any T N1
Any N M0
M1
Prostate Stage 1 Mortality
100% 5Year Survival
Prostate Stage 2 Mortality
100% 5 Year Survival
Prostate Stage 3 Mortality
95% 5 year Survival
Prostate Stage 4 Mortality
50% 5 Year Survival
Prostate Low Risk PSA
<10
Prostate Intermediate Risk PSA
10-20
Prostate High Risk PSA
> 20
Prostate Low Risk Gleeson
3+3=6
Prostate Intermediate Risk Gleeson
3+4/4+3=7
Prostate High Risk Gleeson
> 7
Prostate Low Risk T Stage
=
Prostate Intermediate Risk T Stage
=
Prostate High Risk T Stage
=>T3
Prostate IPSS mildly symptomatic
0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic.
Prostate IPSS Moderately symptomatic
0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic.
Prostate IPSS severely symptomatic
0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic.
Prostate Normal Urine flow rate
Uroflowmetry is the measurement of voided urine (in milliliters) per unit of time (in seconds). The important elements of the test are voided volume (which should be >150 mL), maximum flow rate (Qmax), and the curve of the flow (which should be bell shaped). In men, a Qmax >15 mL/s is considered normal, whereas a Qmax <10 mL/s is considered abnormal.
Prostate Max size for Brachytherapy
60cc
Criteria for Active Surveillance
Low to intermediate risk
Followup schedule for AS
PSA estimation (including doubling time (DT)) and DRE every 3-6 months. Early MRI and rebiopsy after 12 months (TRUSS-guided or template).
Active surveillance - progression to treatment:
PSA DT of 2 years or less
Evidence of disease progression on PSA, DRE or rebiopsy
