[Prognostic significance of prostatic carcinoma grading according to Helpap]

The prognostic significance of the subgrading system introduced by Helpap was retrospectively examined in 342 prostatic carcinomas, revealing a distinct decrease on survival rate with increasing grade of malignancy: during the first three years following diagnosis 21 per cent of the patients with carcinomas graded as Ib died, while all patients with grade Ia carcinomas were still alive. Thus, according to our results, a clinical observation, but no further surgical treatment is recommended in grade Ia cases. At the time of diagnosis, 54.3 per cent of our cases were at the stages T3 or T4. 15.4 per cent of the carcinomas were incidental. The majority (52 per cent) of these cases had to be graded as Ia or Ib, but only 14.8 per cent of the non-incidental tumors did belong to these prognostically most favourable groups. In summary, the prostate carcinoma grading system introduced by Helpap is characterized by prognostic significance and good reproducibility, and thus should be part of the routine diagnosis of prostate carcinoma.