The prognostic significance of histological grading and pathological staging in carcinoma of the prostate.

Histological grading and pathological staging are relevant factors in the prognosis of patients with prostatic cancer. Of 115 consecutive patients with carcinoma of the prostate that was staged fully before treatment 16 had stage A2 disease. Low grade neoplasms were present in 6 of these patients and evidence of nodal metastases was documented at lymphadenectomy in 2. Similarly, 4 of 35 patients with low grade stage B1 disease had nodal metastases. With the enzymatic and/or radioimmunoassay techniques for acid phosphatase determination we were unable to select those patients with nodal metastases. From these studies we believe that low grade, low stage carcinoma of the prostate retains a potential for metastatic disease and that acid phosphatase determinations are unreliable in detecting bulky regional nodal involvement.