Pathology of prostatic cancer
Hohbach, C.; Dhom, G.
Scandinavian Journal of Urology and Nephrology. Supplementum 55: 37-47
1980
ISSN/ISBN: 0300-8886 PMID: 6938034 Document Number: 154774
From 1972 to 1975, 6758 clinical prostatic carcinomas were recorded at the prostatic carcinoma registry in Homburg/Saar. 52% of the patients are between the age of 65 and 75, 22% younger than 65. We distinguish between 4 basic types: the highly and poorly differentiated adenocarcinomas, the cribriform and solid anaplastic carcinomas. 46% of the carcinomas are of uniform architecture, 54% are pluriform differentiated whereby very often the cribriform carcinoma is present. 82% of all the cases and over 70% of the carcinomas in men under the age of 55 can be allotted to the stages B to D according to FLOCKS. All histologic patterns are found in young as well as in old men. Fastly proliferating and poorly differentiated prostatic carcinomas are predominant. Contrary to these features there are in stage 0 and the latent carcinoma highly differentiated adenocarcinomas in 41.8%, e.g. 57% with obviously low malignancy. They remain symptom-free so that they are only discovered incidentally during lifetime or during autopsy. The incidental carcinoma represents only 7% of the biopsy volume, the latent carcinoma 36.4% in men after the age of 45. Its frequency, the number of tumour foci and extension in the prostate increase with progressing age. The course of the clinical prostatic carcinoma under therapy can be controlled via biopsy. Thus, it is possible to discover in about 20% of the cases primarily therapy-resistant tumours. Other tumours show a complete regression and aside we find tumours with temporary regression and further tumour progression. Primarily resistant to conservative treatment are the transitional cell carcinomas of the prostate which, therefore, have to be differentiated from the solid prostatic carcinomas.