Histologic grading of prostatic carcinoma.

The histologic pattern of differentiation of prostate carcinoma and its grade of nuclear anaplasia was correlated with survival time in 197 patients with treated disease. In the histologic classification of prostatic carcinoma (Hohbach and Dhom, 1972) four patterns of growth are distinguished, which have different life expectancies. The survival probabilities of treated well and poorly differentiated adenocarcinoma do not show a significant difference when compared to age-matched male control groups. However, the survival probabilities in patients with cribriform and anaplastic carcinoma are significantly poorer. Even in metastatic carcinoma, the histologic pattern of differentiation seems to influence the survival probability. The grade of nuclear anaplasia (mild, moderate, marked) correlates well with the survival probability as well. The survival probability of patients with mild nuclear anaplasia does not differ from age-matched healthy males. Thus, a combined grading system (grades 0-5) is suggested which combines histologic pattern and nuclear anaplasia. In tumors with several structural patterns the most poorly differentiated one is evaluated. The reproducibility and validity of prognostic statements is more significant with the combined grading system than with only one single diagnostic criterion.