Is Extraprostatic Extension bad?
Extraprostatic extension (EPE) is an adverse prognostic factor for prostate cancer (PCa) and is defined as an extension of tumor into periprostatic soft tissue.
What does Extraprostatic extension present mean?
CS3. 03a Extraprostatic extension (EPE) refers to the presence of neoplastic glands outside the prostate in the periprostatic tissue. This became accepted terminology at a 1996 Consensus Conference,57 and replaces terms such as extracapsular or extraglandular invasion, penetration, and perforation.
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.”
Is Extraprostatic extension the same as extracapsular extension?
Extraprostatic (extracapsular) extension of prostate cancer refers to local tumor growth beyond the fibromuscular pseudocapsule of the prostate gland into the periprostatic soft tissues, in particular, the periprostatic fat and is an established adverse prognostic factor and of importance for prostate cancer staging …
What is Extraprostatic disease?
The extraprostatic disease was defined as the invasion of adipose tissue and/or of the periprostatic neurovascular plexus.
What is high grade prostatic intraepithelial neoplasia?
HGPIN refers to proliferation of prostate glandular epithelial cells that display significant cytological atypia within the confines of prostatic ducts and acini. 2. It has been accepted as the main precursor lesion to invasive prostate carcinoma.
What is a normal PSA level after radiation?
Recent studies have shown that for optimal results, PSA levels should be lower than 1 ng/ml, and even lower than 0.5 ng/ml. Levels that are above 1 or 2 ng/ml 12 to 18 months following completion of radiation treatments are very worrisome, because they indicate that the cancer may not have been eradicated.
Can MRI detect Extraprostatic extension?
Summary. MRI grading for extraprostatic extension combined with clinical variables (prostate-specific antigen, Gleason score, and digital rectal examination) showed the highest diagnostic performance for prediction of pathologic extraprostatic extension of prostate cancer.
What does extracapsular extension mean?
If these tumors are not detected and diagnosed early, they have a higher probability of reaching the firm outer edge of the gland, called the capsule, and breaking through it. This is called extracapsular extension (extra means “beyond”, so the tumor has penetrated the capsule and begun growing outside of it).
What does perineural invasion present mean?
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.
Is prostatic intraepithelial neoplasia malignant?
HGPIN and prostate cancer share genetic and molecular markers as well, with PIN representing an intermediate stage between benign epithelium and invasive malignant carcinoma. The clinical significance of HGPIN is that it identifies patients at risk for malignancy.
Is there a predictive value for extraprostatic extension?
[…] Tumor contact length (TCL) is defined as the extent of contact between prostate cancer and the prostatic capsule, and its predictive value for microscopic extraprostatic extension (EPE) has been reported. However, the impact of the zonal origin (anterior or posterior tumor) of the tumor on the diagnosis of EPE is controversial.
What are the risks of extraprostatic extension of prostate cancer?
Extraprostatic extension is associated with a higher risk of recurrence and metastasis and lower cancer-specific survival after radical prostatectomy 1. 1. Mehralivand S, Shih JH, Harmon S, Smith C, Bloom J, Czarniecki M, Gold S, Hale G, Rayn K, Merino MJ, Wood BJ, Pinto PA, Choyke PL, Turkbey B.
What is the impact of Epstein’s method in prostate cancer?
Impact of the extent of extraprostatic extension defined by Epstein’s method in patients with negative surgical margins and negative lymph node invasion The extent of EPE is an independent predictor of BCR in pT3aN0 prostate cancer without PSM.
Which is better for extraprostatic extension CT or MRI?
Though imperfect, MRI is superior to transrectal ultrasound, CT, and digital rectal examination in predicting the likelihood of extracapsular extension. Morphologic predictors of extraprostatic extension at MRI are listed in rough order from most specific to most sensitive 1,3,4: