title: Patterns of progression in prostate cancer.
abstract: Tumour volume was related to metastasis, seminal vesicle invasion, capsule invasion, and histological differentiation in a series of 100 unselected prostates with carcinoma removed at necropsy and 38 removed at radical prostatectomy. All these variables were highly inter-related. In both series, metastases were associated only with tumours larger than 4 ml, a volume attained by only 13% of the necropsy tumours. Loss of differentiation was strongly correlated with tumour volume, and only tumours of Gleason grade 4 or 5 had metastasised. It was concluded that the natural history of prostate cancer is highly predictable. The capacity to metastasise probably develops only in tumours which have grown much larger than 1 ml and acquired poorly differentiated areas as a manifestation of the phenomenon of tumour progression. The unusually low proportion of metastatic prostate cancer is readily explained by the large proportion of small-volume tumours in this organ.
authors.forename: J E
authors.initials: JE
authors.lastname: McNeal
authors.forename: D G
authors.initials: DG
authors.lastname: Bostwick
authors.forename: R A
authors.initials: RA
authors.lastname: Kindrachuk
authors.forename: E A
authors.initials: EA
authors.lastname: Redwine
authors.forename: F S
authors.initials: FS
authors.lastname: Freiha
authors.forename: T A
authors.initials: TA
authors.lastname: Stamey
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000367:Age Factors; D000368:Aged; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009362:Neoplasm Metastasis; D011336:Probability; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012669:Seminal Vesicles / Q000473:pathology