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Staging and Pathology

Pathology

 

The Gleason Score: A Measure of Prostate Cancer Aggressiveness/Invasiveness

Adenocarcinomas make up the vast majority of prostate cancers.The grading system developed by Gleason is the predominant way to measure prostate cancer aggressiveness. The Gleason score is determined by how abnormal the cancer cells appear under the microscope. The Gleason scoring system assigns a number from four to ten for each cancer, with a higher score indicating more invasive cancers.

 

Other tumor types

Cancers, other than adenocarcinomas, are relatively rare and include ductal adenocarcinoma, mucinous adenocarcinoma, transitional carcinoma or small cell cancer.

 

Metastatic spread

Adenocarcinoma of the prostate may spread locally through direct extension into periprostatic fat or via the ejaculatory ducts into seminal vesicles; lymphatically to regional lymph nodes, including the hypogastric and obturator lymph nodes; and to bone. The most common sites of bony metastases are the lumbosacral spine but any bone, including the skull and ribs, can be involved. Rare sites of metastatic spread include the liver and lungs.

 

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