Intraprostatic adipose tissue: a study of 427 whole mount radical prostatectomy specimens

Kee, Keun Hong; Ro, Jae Y.; Jennings, Timothy A.; Ross, Jeffrey S.; Mian, Badar M.; Shen, Steven S.; Suh, Jae Hee; Lee, Mi Ja; Ayala, Alberto G.

doi:10.1016/j.humpath.2008.10.004

Cited by 22 publications

(10 citation statements)

References 4 publications

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“…To diagnose EPE on needle biopsy, we rely on the finding of adenocarcinoma infiltrating periprostatic adipose tissue. Intraprostatic adipose tissue is an exceedingly rare phenomenon [21–24]. This finding might question the practice of diagnosing EPE based on tumour seen in fat on biopsy.…”

Section: Discussionmentioning

confidence: 99%

Extraprostatic extension of prostatic adenocarcinoma on needle core biopsy: report of 72 cases with clinical follow‐up

Miller

Chen

et al. 2010

BJU International

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Study Type – Prognosis (case series) Level of Evidence 4 OBJECTIVE To describe the histological findings and prognosis that are associated with extraprostatic extension (EPE) on needle core biopsy of prostatic adenocarcinoma. PATIENTS AND METHODS We retrieved 99 cases of prostatic adenocarcinoma with EPE at initial diagnosis on biopsy from the consultation files of one of the authors between 1997 and 2009. The 72 cases that had available clinical follow‐up data formed the basis of this study. RESULTS The mean (range) age of the patients was 64 (48–87) years, the median (mean, range) serum prostatic specific antigen level was 7.8 (64.8, 0.3–1505) ng/mL, and 60 of the patients (83%) had abnormalities on a digital rectal examination. The mean (range) number of malignant cores was 7.7 (1–23); the mean percentage of carcinoma in each core was 69.6%, and that in the core(s) with EPE was 76.8%. The mean Gleason score in the core(s) with EPE was 8, with a mean highest Gleason score per case of 8.4. Perineural invasion was detected in 54 cases (75%). Ten of 11 patients treated surgically had EPE on the radical prostatectomy (RP) specimen; also six had positive resection margins, five showed invasion into the seminal vesicles and one had lymph node metastasis. The Gleason scores in nine of the RP specimens did not differ from the highest grade found in the associated biopsies (score 9 in three, 8 in two, 7 in four); in one case it increased (from score 6 to 8) and in one it decreased (from score 9 to 8). Patients were followed for a mean (median, range) of 2.9 (2, 0.1–9) years, with metastases identified in 29 (40%); 10 (14%) died from the disease. CONCLUSION EPE on needle core biopsy of the prostate is strongly associated with extensive, high‐grade prostatic adenocarcinoma, such that its usefulness as an isolated prognostic factor is relatively limited.

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Section: Discussionmentioning

confidence: 99%

Extraprostatic extension of prostatic adenocarcinoma on needle core biopsy: report of 72 cases with clinical follow‐up

Miller

Chen

et al. 2010

BJU International

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“…Whereas intraprostatic adipocytes are extremely rare , the extracapsular extension of PCa into the PPAT promotes tumour‐adipocyte cross‐talk because of the close proximity of these cell populations. This cross‐talk may be further amplified by the increased number of pre‐adipocytes observed in PPAT from patients with PCa compared to patients with BPH , and PPAT being richer in adipocyte precursors than other visceral adipose tissue .…”

Section: Potential Mechanistic Links Between Peri‐prostatic Adipose Tmentioning

confidence: 99%

Peri‐prostatic adipose tissue: the metabolic microenvironment of prostate cancer

et al. 2018

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Emerging data have linked certain features of clinical prostate cancer (PCa) to obesity and, more specifically, increased adiposity. Whereas the large number of clinical studies and meta-analyses that have explored the associations between PCa and obesity have shown considerable variability, particularly in relation to prostate cancer risk, there is an accumulating weight of evidence consistently linking obesity to greater aggressiveness of disease. In probing this association mechanistically, it has been posited that peri-prostatic adipose tissue (PPAT), a significant component of the prostate microenvironment, may be a critical source of fatty acids and other mitogens and thereby influences PCa pathogenesis and progression. Notably, several recent studies have identified secreted factors from both PPAT and PCa that potentially mediate the two-way communication between these intimately linked tissues. In the present review, we summarize the available literature regarding the relationship between PPAT and PCa, including the potential biological mediators of that relationship, and explore emerging areas of interest for future research endeavours.

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“…It has been suggested that extra-prostatic extension can be assessed on some prostate biopsies where the margins of the prostate have been sampled and invasion of fat assessed [ 29 ]. More recent studies have shown the presence of rare small fat foci within the prostate often mixed with benign glands [ 30 , 31 ]. However in most cases it should be possible to distinguish extraprostatic fat from foci within the prostate to perineural invasion.…”

Section: Discussionmentioning

confidence: 99%

Should reporting of peri-neural invasion and extra prostatic extension be mandatory in prostate cancer biopsies? correlation with outcome in biopsy cases treated conservatively

et al. 2018

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The identification of perineural invasion (PNI) and extraprostatic extension (ECE) in prostate cancer (PC) biopsies is time consuming and can be difficult. Although this is required information in many datasets, there is little evidence on their effect on outcome in patients treated conservatively. Cases of PC were identified from three cancer registries in the UK from men with clinically localized prostate cancer diagnosed by needle biopsy from 1990–2003. The endpoint was prostate cancer death (DOD). Patients treated radically within 6 months, those with objective evidence of metastases or who had prior hormone therapy were excluded. Follow-up was through cancer registries up until 2012. Deaths were divided into those from PC and those from other causes, according to WHO criteria. 988 biopsy cases (6522 biopsy cores) were centrally reviewed by three uropathologists and assigned a Gleason score and Grade Group (GG). The presence of both PNI and ECE was recorded. Of 988 patients, PNI was present in 288 (DOD = 75) and ECE in 23 (DOD = 5). On univariable analysis PNI was highly significantly associated with DOD (hazard ratio [HR] 2.28, 95% CI: 1.68, 3.1, log-rank test p-value = 4.8 × 10–8), but ECE was not (log-rank test p-value = 0.334). On multivariable analysis with GG, serum PSA (per 10%), clinical stage and extent of disease (per 10%), PNI lost significance (HR 1.16, 95% CI: 0.83, 1.63, likelihood ratio test p-value = 0.371). The utility of routinely examining prostate biopsies for ECE and PNI is doubtful as it is not independently associated with higher grade, stage or prognosis.

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Intraprostatic adipose tissue: a study of 427 whole mount radical prostatectomy specimens

Cited by 22 publications

References 4 publications

Extraprostatic extension of prostatic adenocarcinoma on needle core biopsy: report of 72 cases with clinical follow‐up

Extraprostatic extension of prostatic adenocarcinoma on needle core biopsy: report of 72 cases with clinical follow‐up

Peri‐prostatic adipose tissue: the metabolic microenvironment of prostate cancer

Should reporting of peri-neural invasion and extra prostatic extension be mandatory in prostate cancer biopsies? correlation with outcome in biopsy cases treated conservatively

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