Stages and Grade of Prostate Cancer

Stage A. Non-palpable disease
1.) A1 - local carcinoma found incidentally during TUR
2.) A2 - diffuse involvement of the gland, often multifocal
3.) A3 - a new category, disease detected by PSA screening only. This is by far the biggest category of disease at presentation.

Stage B. Palpable tumor confined to the prostate
1.) B1 - confined to a single lobe and <1.5 style="font-weight: bold;">Stage C. Extracapsular invasion
1.) Cl - extracapsular involvement confined to the periprostatic tissue
2.) C2 - extracapsular involvement of seminal vesicles, bladder, rectum, or pelvic wall

Stage D. Metastatic disease
1.) D1 - disease involving regional lymph nodes (below bifurcation of the aorta)
2.) D2 - more extensive disease, usually bone metastasis

Grade: The Gleasons grading system: sum of the grade of the predominant and less well represented regions of the tumor. This has been a fairly good predictor of nodal invovement and prognosis.