Prostate adenocarcinoma - Revision history

Mikael Häggström: /* Staging */ Ref

2024-06-14T13:48:37Z

Staging: Ref

← Older revision		Revision as of 09:48, 14 June 2024
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	*'''T2''': Organ confined		*'''T2''': Organ confined
	[[File:Histopathology of prostate adenocarcinoma involving adipose tissue.jpg\|thumb\|There may be adipose tissue within the prostate gland, but nevertheless, definite '''fat involvement''' by prostate cancer (as pictures) in a needle biopsy counts as extraprostatic or extracapsular extension.<ref>Image by Mikael Häggström, MD. Reference for implication: {{cite journal\| author=Grignon DJ\| title=Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens. \| journal=Mod Pathol \| year= 2018 \| volume= 31 \| issue= S1 \| pages= S96-109 \| pmid=29297497 \| doi=10.1038/modpathol.2017.167 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29297497 }}</ref>]]		[[File:Histopathology of prostate adenocarcinoma involving adipose tissue.jpg\|thumb\|There may be adipose tissue within the prostate gland, but nevertheless, definite '''fat involvement''' by prostate cancer (as pictures) in a needle biopsy counts as extraprostatic or extracapsular extension.<ref>Image by Mikael Häggström, MD. Reference for implication: {{cite journal\| author=Grignon DJ\| title=Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens. \| journal=Mod Pathol \| year= 2018 \| volume= 31 \| issue= S1 \| pages= S96-109 \| pmid=29297497 \| doi=10.1038/modpathol.2017.167 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29297497 }}</ref>]]
	[[File:Histopathology of prostate adenocarcinoma involving skeletal muscle.jpg\|thumb\|In contrast, skeletal muscle is normally present within the prostate, so involvement thereof does '''not''' count as extraprostatic or extracapsular extension.]]		[[File:Histopathology of prostate adenocarcinoma involving skeletal muscle.jpg\|thumb\|In contrast, skeletal muscle is normally present within the prostate, so involvement thereof does '''not''' count as extraprostatic or extracapsular extension.<ref>Image by Mikael Häggström, MD. Reference for implication: {{cite journal\| author=Ye H, Walsh PC, Epstein JI\| title=Skeletal muscle involvement by limited Gleason score 6 adenocarcinoma of the prostate on needle biopsy is not associated with adverse findings at radical prostatectomy. \| journal=J Urol \| year= 2010 \| volume= 184 \| issue= 6 \| pages= 2308-12 \| pmid=20952012 \| doi=10.1016/j.juro.2010.08.006 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20952012 }} </ref>]]
	*'''T3''': Extraprostatic extension		*'''T3''': Extraprostatic extension
	**'''T3a''': Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck		**'''T3a''': Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck

Mikael Häggström: /* Staging */ Contrasted

2024-06-14T13:46:03Z

Staging: Contrasted

← Older revision		Revision as of 09:46, 14 June 2024
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	*'''T2''': Organ confined		*'''T2''': Organ confined
	[[File:Histopathology of prostate adenocarcinoma involving adipose tissue.jpg\|thumb\|There may be adipose tissue within the prostate gland, but nevertheless, definite '''fat involvement''' by prostate cancer (as pictures) in a needle biopsy counts as extraprostatic or extracapsular extension.<ref>Image by Mikael Häggström, MD. Reference for implication: {{cite journal\| author=Grignon DJ\| title=Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens. \| journal=Mod Pathol \| year= 2018 \| volume= 31 \| issue= S1 \| pages= S96-109 \| pmid=29297497 \| doi=10.1038/modpathol.2017.167 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29297497 }}</ref>]]		[[File:Histopathology of prostate adenocarcinoma involving adipose tissue.jpg\|thumb\|There may be adipose tissue within the prostate gland, but nevertheless, definite '''fat involvement''' by prostate cancer (as pictures) in a needle biopsy counts as extraprostatic or extracapsular extension.<ref>Image by Mikael Häggström, MD. Reference for implication: {{cite journal\| author=Grignon DJ\| title=Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens. \| journal=Mod Pathol \| year= 2018 \| volume= 31 \| issue= S1 \| pages= S96-109 \| pmid=29297497 \| doi=10.1038/modpathol.2017.167 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29297497 }}</ref>]]
			[[File:Histopathology of prostate adenocarcinoma involving skeletal muscle.jpg\|thumb\|In contrast, skeletal muscle is normally present within the prostate, so involvement thereof does '''not''' count as extraprostatic or extracapsular extension.]]
	*'''T3''': Extraprostatic extension		*'''T3''': Extraprostatic extension
	**'''T3a''': Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck		**'''T3a''': Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck

Mikael Häggström: /* Staging */ +Adipose

2024-06-14T13:38:06Z

Staging: +Adipose

← Older revision		Revision as of 09:38, 14 June 2024
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	;Evaluation of the (primary) tumor ('T')		;Evaluation of the (primary) tumor ('T')
	*'''T2''': Organ confined		*'''T2''': Organ confined
			[[File:Histopathology of prostate adenocarcinoma involving adipose tissue.jpg\|thumb\|There may be adipose tissue within the prostate gland, but nevertheless, definite '''fat involvement''' by prostate cancer (as pictures) in a needle biopsy counts as extraprostatic or extracapsular extension.<ref>Image by Mikael Häggström, MD. Reference for implication: {{cite journal\| author=Grignon DJ\| title=Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens. \| journal=Mod Pathol \| year= 2018 \| volume= 31 \| issue= S1 \| pages= S96-109 \| pmid=29297497 \| doi=10.1038/modpathol.2017.167 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29297497 }}</ref>]]
	*'''T3''': Extraprostatic extension		*'''T3''': Extraprostatic extension
	**'''T3a''': Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck		**'''T3a''': Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck

Mikael Häggström: Moved from Prostate

2024-03-08T18:30:30Z

Moved from Prostate

← Older revision		Revision as of 14:30, 8 March 2024
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	{{Top		<noinclude>{{Top
	\|author1=[[User:Mikael Häggström\|Mikael Häggström]]		\|author1=[[User:Mikael Häggström\|Mikael Häggström]]
	\|author2=		\|author2=
	\|author3=		\|author3=
	}}		}}

	{{Comprehensiveness}}		{{Comprehensiveness}}
			</noinclude>
	==Gross processing==		==Gross processing==
	As '''[[prostatectomy]]''' or biopsy.		As '''[[prostatectomy]]''' or biopsy.
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	{{Evaluation}}		{{Evaluation}}

	==~~=Report=~~==		==Reporting==
	*'''Diagnosis'''		*'''Diagnosis'''
	*'''Gleason score''', and optionally grade group		*'''Gleason score''', and optionally grade group
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	:*Any '''perineural''' or '''angiolymphatic''' invasion.		:*Any '''perineural''' or '''angiolymphatic''' invasion.
	:*{{Comprehensive-begin}}Any '''inflammation'''.<ref name=inflammation group=notes/>{{Comprehensive-end}}		:*{{Comprehensive-begin}}Any '''inflammation'''.<ref name=inflammation group=notes/>{{Comprehensive-end}}

			Examples in a '''biopsy with adenocarcinoma''':
	{\|class=wikitable		{\|class=wikitable
	\| (Prostate, left apex, needle biopsy:)<br>Prostatic adenocarcinoma, Gleason score 3+3 = 6 (grade group 1), involving 30% of out of one core.		\| (Prostate, left apex, needle biopsy:)<br>Prostatic adenocarcinoma, Gleason score 3+3 = 6 (grade group 1), involving 30% of one out of one core.
	\|}		\|}
	If the microscopy and gross description give discordant number of cores, you may use the gross number.		If the microscopy and gross description give discordant number of cores, you may use the gross number.

			{\|class=wikitable
			\| Prostate, right apex, needle biopsy:
			*Prostatic adenocarcinoma, Gleason score 3+4 = 7 (grade group 2), discontinuously involving ~50% of the specimen (one out of two cores contain carcinoma), with 4 mm linear involvement.
			*Gleason pattern 4 comprises ~10% of carcinoma.
			*Perineural invasion is identified.
			\|}

			Template for '''prostatectomy''':
			{\|class=wikitable
			\| Prostate and seminal vesicles, radical robotic prostatectomy:
			*Prostatic adenocarcinoma, Gleason score __+__=__ (grade group __).
			*Carcinoma involves approximately __% of the submitted tissue.
			*<Positive / Negative> for extraprostatic extension.
			*<Positive / Negative> for perineural invasion.
			*<Positive / Negative> for for lymphovascular invasion.
			*Surgical margins are <positive / negative> for carcinoma.
			*See synoptic report.
			\|}
			{{CAP}}
	===Percentage===		===Percentage===
	In '''prostatectomies''', percentage of involvement can be estimated by marking the tumor edges with a marker pen under the microscope, and looking at the slide without microscope to roughly estimate the percentage of involvement. The total percentage can be calculated as the average of the involvement of each slide.		In '''prostatectomies''', percentage of involvement can be estimated by marking the tumor edges with a marker pen under the microscope, and looking at the slide without microscope to roughly estimate the percentage of involvement. The total percentage can be calculated as the average of the involvement of each slide.

	In '''biopsies''', percentage of involvement can be estimated by first estimating what percentage of the field-of-view diameter the tumorous area occupies, or how many field-of-view diameters it occupies, divided by how many field-of-view diameters the entire biopsy occupies. When there is at least 1 mm of non-involved segment between separate tumor foci in a biopsy, give the percentage as if the tumor involved such segments too, but denote it as '''"discontinuously"''' involving it.		In '''biopsies''', percentage of involvement can be estimated by first estimating what percentage of the field-of-view diameter the tumorous area occupies, or how many field-of-view diameters it occupies, divided by how many field-of-view diameters the entire biopsy occupies. When there is at least 1 mm of non-involved segment between separate tumor foci in a biopsy, give the percentage as if the tumor involved such segments too, but denote it as '''"discontinuously"''' involving it.
			<noinclude>{{Reporting}}
	~~{{CAP}}~~
	{{Reporting}}
	{{Bottom}}		{{Bottom}}
			</noinclude>

Mikael Häggström: /* Microscopic evaluation */ Templated

2022-12-19T20:59:00Z

Microscopic evaluation: Templated

@@ Line 11: / Line 11: @@
 ==Microscopic evaluation==
 {{Prostate screening method}}
 ===Subdiagnoses===
 [[File:Prostate cancer types.png|thumb|300px|Pie chart of subdiagnoses.<ref group="notes" name="mixed"/>]]

Mikael Häggström: /* Characteristics */ In particular

2022-12-07T18:58:47Z

Characteristics: In particular

← Older revision		Revision as of 14:58, 7 December 2022
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	;Specific but relatively rare signs of adenocarcinoma:<ref group="notes">"Rare" here refers to prevalence at least in core biopsies.(Cruz 2016)</ref>		;Specific but relatively rare signs of adenocarcinoma:<ref group="notes">"Rare" here refers to prevalence at least in core biopsies.(Cruz 2016)</ref>
	<gallery mode=packed heights=180>		<gallery mode=packed heights=180>
	File:Histopathology of prostatic adenocarcinoma with circumferential perineural invasion.jpg\|'''Perineural invasion'''.<ref name="CruzSantana2016"/> It should be circumferential (as pictured) to count.<ref name=Stanford-prostate-adenoca>{{cite web\|url=http://surgpathcriteria.stanford.edu/prostate/adenocarcinoma/\|title=Prostatic Adenocarcinoma\|website=Stanford Medical School\|author=Robert V Rouse MD}} Last update 2/2/16~~</ref><ref group="notes>Glands adjacent to and indenting nerves is not sufficient as a diagnostic criterion by itself. Glands partially surrounding a nerve is an indication of carcinoma. (Stanford)~~</ref>		File:Histopathology of prostatic adenocarcinoma with circumferential perineural invasion.jpg\|'''Perineural invasion'''.<ref name="CruzSantana2016"/> It should be circumferential (as pictured) to count.<ref name=Stanford-prostate-adenoca>{{cite web\|url=http://surgpathcriteria.stanford.edu/prostate/adenocarcinoma/\|title=Prostatic Adenocarcinoma\|website=Stanford Medical School\|author=Robert V Rouse MD}} Last update 2/2/16</ref>
	</gallery>		</gallery>
			On biopsies, look in particular near the tips for perineural invasion, as it is most likely seen by the capsule. Glands adjacent to and indenting nerves is not sufficient as a diagnostic criterion by itself. Glands partially surrounding a nerve is an indication of carcinoma.<ref name=Stanford-prostate-adenoca/>
	*'''Collagenous micronodules''' for acinar adenocarcinoma<ref name="CruzSantana2016"/>		*'''Collagenous micronodules''' for acinar adenocarcinoma<ref name="CruzSantana2016"/>
	*'''Angiolymphatic''' invasion<ref name="CruzSantana2016"/>		*'''Angiolymphatic''' invasion<ref name="CruzSantana2016"/>

Mikael Häggström: /* Gleason scoring */ Comprehensive

2022-11-18T01:15:20Z

Gleason scoring: Comprehensive

← Older revision		Revision as of 21:15, 17 November 2022
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	</gallery>		</gallery>

	The '''percentage of pattern 4''' should be reported ~~in all~~ Gleason score ~~7 (~~3+4, 4+3~~) cases~~.<ref>{{cite web\|url=https://documents.cap.org/protocols/Prostate.Needle.Case.Bx_1.0.0.1.REL_CAPCP.pdf\|title=Protocol for the Examination of Prostate Needle Biopsies From Patients With Carcinoma of the Prostate Gland: Case Level Reporting\|website=College of American Pathologists}} Version: 1.0.0.1. Protocol Posting Date: November 2021</ref>		The '''percentage of pattern 4''' should be reported for Gleason score 3+4 {{Comprehensive-begin}}and 4+3{{Comprehensive-end}}.<ref>{{cite web\|url=https://documents.cap.org/protocols/Prostate.Needle.Case.Bx_1.0.0.1.REL_CAPCP.pdf\|title=Protocol for the Examination of Prostate Needle Biopsies From Patients With Carcinoma of the Prostate Gland: Case Level Reporting\|website=College of American Pathologists}} Version: 1.0.0.1. Protocol Posting Date: November 2021</ref>

	In case of '''3 patterns''' in one specimen:<ref name="MOLAVI p. ">{{cite book \| last=MOLAVI \| first=DIANA WEEDMAN \| title=PRACTICE OF SURGICAL PATHOLOGY : a beginner's guide to the diagnostic process. \| publisher=SPRINGER INTERNATIONAL PU \| publication-place=[Place of publication not identified] \| date=2018 \| isbn=3-319-86570-6 \| oclc=1085201203 \| page=}}</ref>		In case of '''3 patterns''' in one specimen:<ref name="MOLAVI p. ">{{cite book \| last=MOLAVI \| first=DIANA WEEDMAN \| title=PRACTICE OF SURGICAL PATHOLOGY : a beginner's guide to the diagnostic process. \| publisher=SPRINGER INTERNATIONAL PU \| publication-place=[Place of publication not identified] \| date=2018 \| isbn=3-319-86570-6 \| oclc=1085201203 \| page=}}</ref>

Mikael Häggström: /* Gleason scoring */ Percentage

2022-08-18T14:34:36Z

Gleason scoring: Percentage

← Older revision		Revision as of 10:34, 18 August 2022
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	</gallery>		</gallery>

	In case of 3 patterns in one specimen:<ref name="MOLAVI p. ">{{cite book \| last=MOLAVI \| first=DIANA WEEDMAN \| title=PRACTICE OF SURGICAL PATHOLOGY : a beginner's guide to the diagnostic process. \| publisher=SPRINGER INTERNATIONAL PU \| publication-place=[Place of publication not identified] \| date=2018 \| isbn=3-319-86570-6 \| oclc=1085201203 \| page=}}</ref>		The '''percentage of pattern 4''' should be reported in all Gleason score 7 (3+4, 4+3) cases.<ref>{{cite web\|url=https://documents.cap.org/protocols/Prostate.Needle.Case.Bx_1.0.0.1.REL_CAPCP.pdf\|title=Protocol for the Examination of Prostate Needle Biopsies From Patients With Carcinoma of the Prostate Gland: Case Level Reporting\|website=College of American Pathologists}} Version: 1.0.0.1. Protocol Posting Date: November 2021</ref>

			In case of '''3 patterns''' in one specimen:<ref name="MOLAVI p. ">{{cite book \| last=MOLAVI \| first=DIANA WEEDMAN \| title=PRACTICE OF SURGICAL PATHOLOGY : a beginner's guide to the diagnostic process. \| publisher=SPRINGER INTERNATIONAL PU \| publication-place=[Place of publication not identified] \| date=2018 \| isbn=3-319-86570-6 \| oclc=1085201203 \| page=}}</ref>
	*On a '''biopsy''': most common pattern + the highest pattern. For example, mostly pattern 3, a bit of 4, and a tiny bit of 5 would be graded 3 + 5 = 8.		*On a '''biopsy''': most common pattern + the highest pattern. For example, mostly pattern 3, a bit of 4, and a tiny bit of 5 would be graded 3 + 5 = 8.
	*On a '''prostatectomy''': First and second most prevalent patterns, and if there is a minor or third component of higher grade, that is termed a tertiary pattern. The same example as above would be classified as 3 + 4 = 7 with tertiary pattern 5.		*On a '''prostatectomy''': First and second most prevalent patterns, and if there is a minor or third component of higher grade, that is termed a tertiary pattern. The same example as above would be classified as 3 + 4 = 7 with tertiary pattern 5.

Mikael Häggström: /* Gleason scoring */ 3 Patterns

2022-07-26T17:45:19Z

Gleason scoring: 3 Patterns

← Older revision		Revision as of 13:45, 26 July 2022
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	File:Micrograph of prostate cancer with Gleason score 10 (5+5) with solid sheets of cells.jpg\|Gleason score 10 (5+5) with '''solid sheets''' of cells		File:Micrograph of prostate cancer with Gleason score 10 (5+5) with solid sheets of cells.jpg\|Gleason score 10 (5+5) with '''solid sheets''' of cells
	</gallery>		</gallery>

			In case of 3 patterns in one specimen:<ref name="MOLAVI p. ">{{cite book \| last=MOLAVI \| first=DIANA WEEDMAN \| title=PRACTICE OF SURGICAL PATHOLOGY : a beginner's guide to the diagnostic process. \| publisher=SPRINGER INTERNATIONAL PU \| publication-place=[Place of publication not identified] \| date=2018 \| isbn=3-319-86570-6 \| oclc=1085201203 \| page=}}</ref>
			*On a '''biopsy''': most common pattern + the highest pattern. For example, mostly pattern 3, a bit of 4, and a tiny bit of 5 would be graded 3 + 5 = 8.
			*On a '''prostatectomy''': First and second most prevalent patterns, and if there is a minor or third component of higher grade, that is termed a tertiary pattern. The same example as above would be classified as 3 + 4 = 7 with tertiary pattern 5.

	{{Comprehensive-begin}}In cases of Gleason pattern 3+4 and 4+3, also state the percentage of Gleason pattern 4 compared to the entire tumor area.<ref name="pmid30363387">{{cite journal\| author=Sharma M, Miyamoto H\| title=Percent Gleason pattern 4 in stratifying the prognosis of patients with intermediate-risk prostate cancer. \| journal=Transl Androl Urol \| year= 2018 \| volume= 7 \| issue= Suppl 4 \| pages= S484-S489 \| pmid=30363387 \| doi=10.21037/tau.2018.03.20 \| pmc=6178316 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30363387 }} </ref>{{Comprehensive-end}}		{{Comprehensive-begin}}In cases of Gleason pattern 3+4 and 4+3, also state the percentage of Gleason pattern 4 compared to the entire tumor area.<ref name="pmid30363387">{{cite journal\| author=Sharma M, Miyamoto H\| title=Percent Gleason pattern 4 in stratifying the prognosis of patients with intermediate-risk prostate cancer. \| journal=Transl Androl Urol \| year= 2018 \| volume= 7 \| issue= Suppl 4 \| pages= S484-S489 \| pmid=30363387 \| doi=10.21037/tau.2018.03.20 \| pmc=6178316 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30363387 }} </ref>{{Comprehensive-end}}

Mikael Häggström: /* Staging */ Updated

2022-07-21T14:09:45Z

Staging: Updated

← Older revision		Revision as of 10:09, 21 July 2022
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	*Prostatectomy: Stage by TNM:		*Prostatectomy: Stage by TNM:

	~~From the~~ AJCC ~~7th~~ edition<ref ~~name="AJCC 7th ed."~~>{{~~cite book\|title=~~AJCC ~~cancer staging manual.\|last1=American Joint Committee on Cancer. Edge, Stephen B, ed.\|date=2010\|publisher=Springer\|isbn=9780387884400\|edition=7th\|location=New York~~\|~~page~~=~~457–468~~}}</ref> ~~and International Union Against Cancer~~ (~~UICC~~) ~~7th edition~~.~~<ref name="UICC TNM">{{cite web\|title=TNM {{!}} UICC\|url=https~~:~~//www.uicc.org/resources/tnm\|website=Union for International Cancer Control\|accessdate=11 November 2017\|language=en}}</ref>~~		The AJCC 8th edition<ref>{{AJCC-8\|chapter=58 - Prostate}}</ref> has a shorter pathological tumor classification (pT) than the clinical one (cT). pT does not have any T1 category, and is as follows:

	;Evaluation of the (primary) tumor ('T')		;Evaluation of the (primary) tumor ('T')
	*'''TX''': ~~cannot evaluate the primary tumor~~		*'''T2''': Organ confined
	*'''~~T0''': no evidence of tumor~~		*'''T3''': Extraprostatic extension
	*'''T1''': ~~tumor present, but not detectable clinically or with imaging~~		**'''T3a''': Extraprostatic extension (unilateral or bilateral) or microscopic invasion of bladder neck
	**'''~~T1a~~''': ~~tumor was incidentally found in 5%~~ or ~~less of prostate tissue resected (for other reasons~~)		**'''T3b''': Tumor invades seminal vesicle(s)
	**'''T1b''': tumor was incidentally found in greater than 5% of ~~prostate tissue resected~~		*'''T4''': Tumor is fixed or invades adjacent structures other than seminal vesicles such as external sphincter, rectum, bladder, levator muscles, and/or pelvic wall
	**'''~~T1c~~''': ~~tumor was found in a needle biopsy performed due to an elevated serum PSA~~
	*'''T2''': the tumor can be felt (~~palpated~~) ~~on examination, but has not spread outside the prostate~~
	**'''~~T2a~~''': ~~the tumor~~ is ~~in half~~ or ~~less~~ than ~~half of one of the prostate gland's two lobes~~
	**'''T2b''': the tumor is in more than half of one lobe, ~~but not both~~
	**'''T2c''': the tumor is in both lobes but within the prostatic capsule
	*'''T3''': the tumor has spread through the prostatic capsule (if it is only part-way through, ~~it is still '''T2''')~~
	**'''T3a''': the tumor has spread through the capsule on one or both sides
	**'''T3b''': the tumor has invaded one or ~~both seminal vesicles~~
	*'''T4''': the tumor has invaded other nearby structures

	;Evaluation of the regional lymph nodes ('N')		;Evaluation of the regional lymph nodes ('N')
	*'''NX''': ~~cannot evaluate the regional~~ lymph nodes		*'''NX''': Regional lymph nodes cannot be assessed
	*'''N0''': ~~there has been no spread to the~~ regional ~~lymph~~ nodes		*'''N0''': No positive regional nodes
	*'''N1''': ~~there has been spread to the~~ regional ~~lymph nodes~~		*'''N1''': Metastases in regional node(s)

	;Evaluation of distant metastasis ('M')		;Evaluation of distant metastasis ('M')
	*'''MX''': cannot evaluate distant metastasis		*'''M0''': No distant metastasis
	*'''M0''': ~~there is no~~ distant metastasis		*'''M1''': Distant metastasis
	*'''M1''': ~~there is distant~~ metastasis		**'''M1a''': Nonregional lymph node(s)
	**'''M1a''': ~~the cancer has spread to~~ lymph ~~nodes beyond the regional ones~~		**'''M1b''': Bone(s)
	**'''M1b''': ~~the cancer has spread to bone~~		**'''M1c''': Other site(s) with or without bone disease
	**'''M1c''': ~~the cancer has spread to other sites~~ (~~regardless~~ of ~~bone involvement)~~		When more than one site of metastasis is present, the most advanced category is used.
			{{CAP}}
	{{Evaluation}}		{{Evaluation}}

	===Report===		===Report===
	*'''Diagnosis'''		*'''Diagnosis'''