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November 1958

Carcinoma of the Prostate: A New System of Classification

Author Affiliations

Nashville, Tenn.
From the Veterans' Administration Hospital.

AMA Arch Surg. 1958;77(5):751-756. doi:10.1001/archsurg.1958.01290040099012

In 1925 Broders1 presented a method whereby the degree of malignancy of a tumor could be assessed, recorded, and communicated readily to the clinician. Realizing that the percentage of undifferentiated cells determines the malignant potential, he based his system on the ratio of these to the differentiated cells as follows:

Grade 1 here, then, represents the least malignant tumors, whereas Grade 4 represents the most malignant tumors.

He graded and followed 880 epitheliomas, finding a very close correlation between the tumor grade and the therapeutic result.

Subsequently, this excellent system has been applied to carcinoma of the prostate. Here, too, the grade and prognosis are related and vary proportionately. Table 1 shows the percentage of patients with metastases in Kahler's4 cases and the survival figures for Thompson's7 and Pool and Thompson's6 series. The increase in metastases and the worsening of prognosis with the increase in grade