Is Extraprostatic Extension Bad?

Extraprostatic extension (EPE) is defined as local spread of prostate cancer (PC) beyond prostate boundaries. Although extensively evaluated in radical prostatectomy (RP) specimens, its significance in prostate biopsy (PB) specimens is understudied.

What does Extraprostatic mean?

Introduction. Extraprostatic extension (EPE) on histopathological examination refers to the identification of tumor cells beyond the borders of the prostate, most often recognized as tumor intermingling with periprostatic adipose tissue.

What is non focal Extraprostatic extension?

Focal is defined as extraprostatic glands which occupy no more than one high power field on no more than two sections, often described as “established”. Extensive EPE represents anything more than this and is often described as “non-focal”.

What is Periprostatic tissue?

Abstract. Prostate is surrounded by a specific fat depot called periprostatic adipose tissue (PPAT) that contributes through paracrine mechanisms to prostate cancer (PCa) progression. Like other white adipose tissues, PPAT stores lipids and is an endocrine organ. However, PPAT is still poorly characterized.

What is the meaning of perineural invasion?

Perineural invasion means that cancer cells were seen surrounding or tracking along a nerve fiber with the prostate. When this is found on a biopsy, it means there is a higher chance that the cancer has spread outside the prostate.

What does pT3a mean?

pT3a: Extraprostatic extension (focal is < 1 high power field in 1 - 2 slides, multifocal is more) or. microscopic invasion of bladder neck (in thick muscle, no adjacent nonneoplastic glands) pT3b: Seminal vesicle muscle wall invasion. pT4: Invasion of external sphincter, rectum, bladder, levator muscles or pelvic wall.

Where is the incision for prostate surgery?

Your surgeon makes an incision in your lower abdomen, from below your navel to just above your pubic bone. After carefully dissecting the prostate gland from surrounding nerves and blood vessels, the surgeon removes the prostate along with nearby tissue. The incision is then closed with sutures.

What is high-grade PIN?

High-grade prostatic intraepithelial neoplasia is considered the most likely precursor of prostatic carcinoma. The only method of detection is biopsy; prostatic intraepithelial neoplasia (PIN) does not significantly elevate serum prostate-specific antigen concentration and cannot be detected by ultra-sonography.

What is the most aggressive form of prostate cancer?

Ductal prostate cancer is usually more aggressive than common prostate cancer. Possible treatment options include surgery, hormone therapy, radiotherapy and chemotherapy, depending on whether your cancer has grown and spread to other parts of your body.

What is the best treatment for extracapsular extension prostate cancer?

The researchers concluded, “Adjuvant radiotherapy following radical prostatectomy is generally well tolerated and prolongs biochemical recurrence-free survival compared with radical prostatectomy alone in patients with positive margins or extracapsular extension.”

How serious is perineural invasion?

Perineural invasion means that cancer cells were seen surrounding or tracking along a nerve fiber within the prostate. When this is found on a biopsy, it means that there is a higher chance that the cancer has spread outside the prostate.

What does Pi RADS 4 lesion mean?

PI-RADS 4: high (clinically significant cancer is likely to be present) PI-RADS 5: very high (clinically significant cancer is highly likely to be present)

What is a Gleason score of 7?

A Gleason score of 7 is a medium-grade cancer, and a score of 8, 9, or 10 is a high-grade cancer. A lower-grade cancer grows more slowly and is less likely to spread than a high-grade cancer.

What is a Han table?

The Han tables were designed to predict the probability of the first evidence of recurrence (detectable PSA level) after surgery. Similar to the Partin tables, the Han tables correlate the three common factors known about a man’s prostate cancer, PSA level, Gleason score, and clinical stage (or pathological stage).

What should you not drink after prostate surgery?

It may be best not to drink too much tea, coffee or alcohol as these can all irritate the bladder. Over 3 or 4 weeks you can gradually return to normal, gentle exercise. However, you should avoid heavy lifting during this time.

What are the side effects of living without a prostate?

The major possible side effects of radical prostatectomy are urinary incontinence (being unable to control urine) and erectile dysfunction (impotence; problems getting or keeping erections). These side effects can also occur with other forms of prostate cancer treatment.

What is the best diet after prostate surgery?

The first few days after your surgery, you should have light foods (sandwich, yogurt, soup, and liquids) until you have your first bowel movement. Avoid foods that can cause gas, such as beans, broccoli, onions, cabbage, and cauliflower.

What stage is pT3b?

Among advanced PCa stages, pT3b (i.e. cancer involving the seminal vesicles) is considered to be associated with occult micrometastatic disease and earlier biochemical and clinical progression; in patients with disease at this stage, the 10-year CSS is greater than 80% when radical surgery is followed by adjuvant or …

What does stage pT3a mean?

According to the AJCC 2010 TNM staging manual, classification of pathological stage T1 and T2 RCC tumors depends solely on size (7 cm or less for pT1 and greater than 7 cm for pT2 lesions limited to the kidney), whereas pT3a tumors are defined by the presence of additional tumor characteristics regardless of tumor size

Is perineural invasion common?

Perineural invasion is common in adenocarcinoma, present in 11%,397 17%,389 and 38%939 of biopsies, and may be the only evidence of malignancy in a needle core.

What are the symptoms of perineural invasion?

The perineural invasion is often asymptomatic. Patients may experience pain, paresthesia, numbness and formication. Sometimes, in advanced cases, complete denervation may induce muscle atrophy.

What is the meaning of perineural?

Medical Definition of perineural

: occurring about or surrounding nervous tissue or a nerve.