Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging

DF Gleason, GT Mellinger - The Journal of urology, 1974 - auajournals.org
DF Gleason, GT Mellinger
The Journal of urology, 1974auajournals.org
DONALD F. GLEASON,* GEORGE T. MELLINGER AND THE VETERANS
ADMINISTRATION COOPERATIVE UROLOGICAL RESEARCH GROUPt Adenocarcinoma
of the prostate is second in incidence only to cancer of the lung among internal
malignancies in men in the United States. The fact that prostatic carcinoma manifests an
unusually wide range of biological potential is reflected in the well known disparity between
incidence and mortality for this disease. Some patients with proved prostatic cancer die …
DONALD F. GLEASON,* GEORGE T. MELLINGER AND THE VETERANS ADMINISTRATION COOPERATIVE UROLOGICAL RESEARCH GROUPt Adenocarcinoma of the prostate is second in incidence only to cancer of the lung among internal malignancies in men in the United States. The fact that prostatic carcinoma manifests an unusually wide range of biological potential is reflected in the well known disparity between incidence and mortality for this disease. Some patients with proved prostatic cancer die within a relatively short time of diagnosis. Others live much longer and many seem to live a normal life span. This wide range of biological malignancy has made it difficult to establish the best treatment for cancer of the prostate. Large numbers of patients must be followed for many years to prove that one treatment has a significant advantage over another. It is axiomatic that no treatment will improve the health of a patient with no symptoms. Similarly, it is difficult to demonstrate a difference in response between 2 treatments in patients who have a long survival, perhaps a normal life span, despite their disease. Such patients will dilute out statistical differences between treatment responses. It may also be difficult to compare treatment in patients with aggressive malignancies unless an effective treatment is available. It would be helpful for treatment comparisons if patients at intermediate risk could be identified from pre-treatment information. Such patients might reveal more decisive differences in response to treatment during a shorter period than an unselected group.
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