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Question

A patient is diagnosed to have a Stage T3a carcinoma of the prostate. Clinically, this implies

The correct answer is
Involvement of both the lobes but the disease has extended through the prostatic capsule

Prostate Cancer Staging Explained

The question asks for the clinical implication of a prostate cancer diagnosis of Stage $T3a$.

Understanding TNM Staging for Prostate Cancer

The TNM staging system classifies cancer based on the Tumor (T), Node (N), and Metastasis (M) extent. For prostate cancer, the 'T' stage is crucial for determining local disease extent:

  • $T1$: Clinically undetectable tumor.
  • $T2$: Tumor confined within the prostate (includes involvement of both lobes but limited to the prostate).
  • $T3$: Tumor extends outside the prostate.
    • $T3a$: Tumor extends *through* the prostatic capsule.
    • $T3b$: Tumor involves seminal vesicles.
  • $T4$: Tumor invades nearby structures like the bladder neck, external sphincter, rectum, pelvic wall, or levator muscles.

Analyzing the Options for Stage $T3a$

Based on the TNM definitions:

  • Option 1 describes a tumor confined within the prostate, possibly affecting both lobes, which aligns with $T2$ stage, not $T3a$.
  • Option 2 accurately describes the tumor extending through the prostatic capsule, which is the definition of $T3a$. This may include involvement of both lobes as the tumor grows.
  • Option 3 (Involvement of the seminal vesicles) corresponds to Stage $T3b$.
  • Option 4 (Involvement of the pelvic wall) corresponds to Stage $T4$.

Therefore, clinically, Stage $T3a$ carcinoma of the prostate implies the disease has extended through the prostatic capsule.

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Important Questions from Urinary System & Surgical Disorders

  1. A 20 years old man had history of pain in the right side of abdomen. His X-ray abdomen AP view shows radio-opaque shadow, which on lateral film falls behind the vertebral column. The probable diagnosis is:
  2. Urinary bladder can be injured in all of the following operations EXCEPT:
  3. Which of the following are correct about ectopic ureters ?
    1. They are more common in males
    2. They drain the upper pole of kidney
    3. They are associated with duplex ureter
    4. They may cause incontinence
    Select the correct answer using the code given below :
  4. Which of the following statements are correct regarding renal cell carcinoma? 

    1. It arises from the epithelium of the proximal convoluted tubule. 

    2. It has a female preponderance. 

    3. Major subtypes are clear cell, papillary and chromophobe. 

    4. Surgery is the mainstay of treatment for disease. organ-confined 

    Select the answer using the code given below.

  5. Which of the following are features of autosomal dominant polycystic kidney disease? 

    1. Cyst may also occur in liver, pancreas and arachnoid membrane. 

    2. Most commonly manifests between 20-30 years of age. 

    3. Clinical manifestations are renal and extrarenal. 

    4. Men tend to progress to renal failure more rapidly than women. 

    Select the correct answer using the code given below.

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