Prostate gland & seminal vesicles

General

Staging



Last author update: 1 April 2018
Last staff update: 30 November 2022 (update in progress)

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PubMed Search: Prostate staging AJCC

Debra L. Zynger, M.D.
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Cite this page: Zynger D. Staging. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/prostatestaging.html. Accessed December 1st, 2022.

Pathologic TNM staging of prostate, AJCC 8th edition
Primary tumor (pT)
  • pT2: Organ confined
  • pT3a: Extraprostatic extension (focal is < 1 high power field in 1 - 2 slides, multifocal is more) or
         microscopic invasion of bladder neck (in thick muscle, no adjacent nonneoplastic glands)
  • pT3b: Seminal vesicle muscle wall invasion
  • pT4: Invasion of external sphincter, rectum, bladder, levator muscles or pelvic wall
Regional lymph nodes (pN)
  • pNX: Cannot be assessed
  • pN0: No regional lymph node metastasis
  • pN1: Regional lymph node metastasis
    (regional lymph nodes = periprostatic, pelvic, hypogastric, obturator, internal iliac, external iliac, sacral)
Distant metastasis (pM)
  • pM1a: Metastasis in nonregional lymph node (ex: aortic, common iliac, deep / superficial inguinal, retroperitoneal)
  • pM1b: Metastasis in bone
  • pM1c: Metastasis in other distant site
AJCC prognostic stage groups (utilizing pT categorization)
Stage group I: pT2 N0 M0  PSA < 10 grade group 1 (Gleason score 3+3=6)
Stage group IIA: pT2 N0 M0 PSA ≥ 10 - < 20 grade group 1 (Gleason score 3+3=6)
Stage group IIB: pT2 N0 M0 PSA < 20 grade group 2 (Gleason score 3+4=7)
Stage group IIC: pT2 N0 M0 PSA < 20 grade group 3 - 4 (Gleason score 4+3=7 and score 8)

Stage group IIIA: pT2 N0 M0 PSA ≥ 20 grade group 1 - 4 (Gleason score 6 - 8)
Stage group IIIB: pT3 - 4 N0 M0 any PSA grade group 1 - 4 (Gleason score 6 - 8)
Stage group IIIC: pT2 - 4 N0 M0 any PSA grade group 5 (Gleason score 9 - 10)
Stage group IVA: pT2 - 4 N1 M0 any PSA grade group 1 - 5
Stage group IVB: pT2 - 4 N0 - 1 M1 any PSA grade group 1 - 5
Gross images

Contributed by Debra Zynger, M.D.

Extraprostatic extension (pT3a)

Seminal vesicle invasion (pT3b)

Microscopic (histologic) images

Contributed by Debra Zynger, M.D.

Extraprostatic extension (pT3a)

Bladder neck invasion (pT3a)

Seminal vesicle invasion, low power (pT3b)

Seminal vesicle invasion, high power (pT3b)

Rectal invasion (pT4)


Periprostatic lymph node metastasis (pN1)

Pelvic lymph node metastasis (pN1)

Neck lymph node metastasis (pM1a)

Bone metastasis (pM1b)

Lung metastasis (pM1c)

Brain metastasis (pM1c)

Brain metastasis (pM1c)

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