Pathology · Neoplasia (Classification, Carcinogenesis, Tumor Markers, Paraneoplastic)

A carcinoma is described as well-differentiated and grade 1 histologically, yet the patient has lymph node metastases (stage III). This scenario illustrates that:

  • A Stage is a better predictor of prognosis than grade in most carcinomas
  • B Grade and stage always correlate with each other
  • C Grade is more important than stage for treatment decisions
  • D Well-differentiated tumors cannot metastasize
Correct answer: A. Stage is a better predictor of prognosis than grade in most carcinomas

Explanation

Stage (extent of spread) is generally a stronger prognostic indicator than histological grade (degree of differentiation). A well-differentiated low-grade tumor can still metastasize; stage trumps grade in determining prognosis and guiding systemic therapy. Grade and stage are independent variables that do not always correlate.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

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