Multiple cancers in the prostate. Morphologic features of clinically recognized versus incidental tumors

@article{Villers1992MultipleCI,
  title={Multiple cancers in the prostate. Morphologic features of clinically recognized versus incidental tumors},
  author={A. Villers and J. McNeal and F. Freiha and T. Stamey},
  journal={Cancer},
  year={1992},
  volume={70}
}
Multiple independent tumors were identified in specimens from 117 of 234 prostatectomies for clinical adenocarcinoma; there were 266 incidental cancers in these 117 prostates. The clinically detected carcinoma was the largest (or only) tumor in all 202 Stage B cases. However, among 32 Stage A cases (detection by transurethral resection), there were 8 prostates in which an incidental tumor was larger than the clinically manifest cancer. These were all small tumors except for two incidental… Expand
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References

SHOWING 1-10 OF 11 REFERENCES
The predictive significance of substaging stage A prostate cancer (A1 versus A2) for volume and grade of total cancer in the prostate.
TLDR
Post-resection serum prostate specific antigen (PSA) levels were elevated with increasing total residual cancer volume in the radical specimen, and unsuspected cancers unrelated to the tumor detected at transurethral resection were found in theradical prostatectomy specimen. Expand
The volume and anatomical location of residual tumor in radical prostatectomy specimens removed for stage A1 prostate cancer.
TLDR
Because some men with stage A1 carcinoma of the prostate will have substantial residual tumor not necessarily detected by repeat transurethral resection and the majority will have minimal residual tumor, which also appears to have an increased long-term risk of progression, radical prostatectomy should remain an option in the management of relatively young men withStage A1 disease. Expand
Histologic differentiation, cancer volume, and pelvic lymph node metastasis in adenocarcinoma of the prostate
The Gleason grading system for prostate cancer was applied quantitatively to analysis of entire tumors in 209 radical prostatectomy specimens from patients with clinical Stage A and Stage BExpand
Unsuspected adenocarcinoma of the prostate in patients undergoing cystoprostatectomy for other causes: incidence, histology and morphometric observations.
TLDR
Possible anatomical explanations and implications of these findings in terms of the apical surgical margins at radical prostatectomy and cystoprostatectomy, and the new technologies currently available for diagnosis of prostate cancer are discussed. Expand
Carcinoma of the prostate: Prognostic evaluation of certain pathologic features in 208 radical prostatectomies
TLDR
Evaluation of various factors affecting survival and mortality disclosed that an extension of the tumor to seminal vesicles or invasion of the capsule, whether detected clinically or pathologically, had an unfavorable prognosis while the side involved, the location of the tumors, and perineural invasion had no significant effect on the prognosis. Expand
The distribution of residual cancer in radical prostatectomy specimens in stage A prostate cancer.
TLDR
The greatest threat to patients with stage A prostate cancer may be a separate, associated cancer in the peripheral zone rather than the primary transition zone cancer incidentally removed at transurethral resection. Expand
Pathologic findings in clinical stage A2 prostate cancer. Relation of tumor volume, grade, and location to pathologic stage
TLDR
Despite statistically significant correlations between tumor percent and/or grade on TUR and final stage, predictability of final stage for individual patients from TUR data was poor and wide and overlapping ranges for these parameters for organ‐confined and nonconfined cases were found. Expand
Morphometric and clinical studies on 68 consecutive radical prostatectomies.
TLDR
It is believed that the modified nerve-sparing radical prostatectomy should be limited to the contralateral side in stage B disease. Expand
Zonal Distribution of Prostatic Adenocarcinoma: Correlation with Histologic Pattern and Direction of Spread
TLDR
It is concluded that carcinoma typically arises in the region of the prostate that is susceptible to benign prostatic hyperplasia and that the great majority of Stage A (TUR) cancers are transition zone cancers. Expand
Evolving patterns of tissue composition in benign prostatic hyperplasia as a function of specimen size.
TLDR
It was concluded that tissue resected for BPH is quite heterogeneous, that nodules comprise most of the tissue only in specimens over 50 g in weight, and that the most common hyperplastic component is histologically normal tissue. Expand
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1
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