Impact of the extent of extraprostatic extension defined by Epstein’s method in patients with negative surgical margins and negative lymph node invasion

Abstract

The extent of EPE is an independent predictor of BCR in pT3aN0 prostate cancer without PSM. This study reinforces the utility of the subjective Epstein approach already adopted by most pathologists for quantification of the extent of EPE.

Impact of United States Preventive Services Task Force recommendations on prostate biopsy characteristics and disease presentation at a tertiary-care medical center

“…Furthermore, when we analyzed patients for signs of locally advanced and metastatic disease before active treatment, patients were found to be 6.3% ( P = 0.039) more likely to have extraprostatic extension, which is a known predictor of biochemical recurrence following radical prostatectomy. 18 Markers for extent of disease were studied, and a modest trend toward an increase in clinically significant pelvic lymph nodes on imaging (1.1% vs. 2.2%, P = 0.078) was found, along with an increase in bony metastases in those patients presenting with metastatic prostate cancer at time of diagnosis (1.7% vs. 3.2%, P = 0.041).…”

A novel tool for predicting extracapsular extension during graded partial nerve sparing in radical prostatectomy

“…ECE is found on pathological analysis of prostate cancer specimens in a significant number of patients with preoperatively clinically localised prostate cancer who undergo RALP . Maubon et al reported that not only the presence, but even the amount of ECE is an independent predictive factor of biochemical recurrence (BCR). Wheeler et al reported a 5‐year BCR rate of 13% in patients with organ‐confined prostate cancer, whereas in patients with local ECE the rate was as high as 27%.…”

“… The large sample size. The adoption of an approach that goes beyond the prediction of the presence of ECE; focusing on the estimation of probabilities of ECE width of >1, >2, >3, and >4 mm, the proposed predictive algorithm yields for each patient and each prostate lobe a graph of the probabilities about the presence and amount of ECE. Unlike previous studies, our present tool provides a decision rule integrated in an interface to make interpretation of outcomes easy for surgeons. The availability of an easy‐to‐use, free, web‐based interface. The diffusion of this tool might improve standardisation and comparability of future studies in terms of PSM. The tool highlights the importance of millimetre‐level ECE measurement. Although the prognostic role of accurate ECE measurement is unclear , it might be useful in order to appropriately compare different series (e.g., the PSM percentage in a series with 1 mm median ECE, might be lower compared to a series with 3 mm median ECE, and this should be related to intrinsic patient characteristics rather than surgical issues). …”

Biochemical recurrence after radical prostatectomy: what does it mean?

“…Extension of EPE has been shown as an independent predictor of BCR in pT3a prostate cancer, even without PSM. However, the diference between focal and non-focal EPE has no impact in PCa specific mortality or overall survival ( 34 , 35 ).…”