Development of prostatic carcinoma. Morphometric and pathologic features of early stages.

The natural history of prostatic adenocarcinoma has been studied in a series of 261 radical prostatectomy specimens from Stanford. Total tumor histologic grade, cancer volume, zonal distribution of the tumor and correlation with its direction of spread, capsular penetration, seminal vesicle invasion and periprostatic extension were quantitated for each case. We identified specific morphologic and histologic features for cancers which arise in the anteromedial transition zone which contains BPH nodules, and for cancers which arise in the posterolateral peripheral zone. Stage A cancers are almost equivalent to transition cancers and stage B cancers to peripheral zone cancers. Prognosis as measured by lymph node metastasis was not different between these two groups of cancers but only related to their volume of poorly differentiated areas.