Failure after radical prostatectomy

Neulander, Endre Z.; Soloway, Mark S.

doi:10.1016/s0090-4295(02)01918-0

Cited by 27 publications

(18 citation statements)

References 48 publications

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“…Correlation of pelvic lymph node and radical prostatectomy findings with postoperative failure Between 15% and 30% of men who undergo radical prostatectomy for prostate cancer will experience biochemical relapse [17]. Most of the relapses will occur within the first 5 years, although late recurrences may also be seen.…”

Section: Sampling For Research Purposesmentioning

confidence: 99%

Prognostic factors and reporting of prostate carcinoma in radical prostatectomy and pelvic lymphadenectomy specimens

Epstein

Amin

Boccon‐Gibod

et al. 2005

Scandinavian Journal of Urology and Nephrology

208

182

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This paper, based on the activity of the Morphology-Based Prognostic Factors Committee of the 2004 World Health Organization-sponsored International Consultation, describes various methods of handling radical prostatectomy specimens for both routine clinical use and research purposes. The correlation between radical prostatectomy findings and postoperative failure is discussed in detail. This includes issues relating to pelvic lymph node involvement, detected both at the time of frozen section and in permanent sections. Issues of seminal vesicle invasion, including its definition, routes of invasion and relationship to prognosis, are covered in detail. The definition, terminology and incidence of extra-prostatic extension are elucidated, along with its prognostic significance relating to location and extent. Margins of resection are covered in terms of their definition, the etiology, incidence and sites of positive margins, the use of frozen sections to assess the margins and the relationship between margin positivity and prognosis. Issues relating to grade within the radical prostatectomy specimen are covered in depth, including novel ways of reporting Gleason grade and the concept of tertiary Gleason patterns. Tumor volume, tumor location, vascular invasion and perineural invasion are the final variables discussed relating to the prognosis of radical prostatectomy specimens. The use of multivariate analysis to predict progression is discussed, together with proposed modifications to the TNM system. Finally, biomarkers to predict progression following radical prostatectomy are described, including DNA ploidy, microvessel density, Ki-67, neuroendocrine differentiation, p53, p21, p27, Bcl-2, Her-2/neu, E-cadherin, CD44, retinoblastoma proteins, apoptotic index, androgen receptor status, expression of prostate-specific antigen and prostatic-specific acid phosphatase and nuclear morphometry.

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Section: Sampling For Research Purposesmentioning

confidence: 99%

Prognostic factors and reporting of prostate carcinoma in radical prostatectomy and pelvic lymphadenectomy specimens

Epstein

Amin

Boccon‐Gibod

et al. 2005

Scandinavian Journal of Urology and Nephrology

208

182

View full text Add to dashboard Cite

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“…1,2 However, despite careful selection of patients, the disease recurs in a substantial percentage of localized PCa cases undergoing curative treatment modalities (i.e., radical prostatectomy and radiotherapy). [3][4][5][6] Accurate prediction of the risk of progression would be useful in choosing the type and timing of the most appropriate treatment. Although existing parameters, such as Gleason sum or preoperative PSA, provide some prognostic information, it is difficult to estimate prognosis in PCa patients since two-thirds of them have Gleason sum of 5-7 and serum PSA levels of 4 -10 ng/ml.…”

mentioning

confidence: 99%

Comparison of the prognostic potential of hyaluronic acid, hyaluronidase (HYAL‐1), CD44v6 and microvessel density for prostate cancer

Ekici

Cerwinka

Duncan

et al. 2004

Intl Journal of Cancer

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Despite the development of nomograms designed to evaluate a prostate cancer (PCa) patient's prognosis, the information has been limited to PSA, clinical stage, Gleason score and tumor volume estimates. We compared the prognostic potential of 4 histologic markers, hyaluronic acid (HA), HYAL-1-type hyaluronidase (HAase), CD44v6 and microvessel density (MVD) using immunohistochemistry. HA is a glycosaminoglycan that promotes tumor metastasis.

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“…Extra-capsular extension, positive surgical margins and Gleason Sum ^ 7 have been correlated with local recurrence while seminal vesicle invasion, positive lymph nodes and a Gleason Sum 1 7 have been correlated with systematic disease [14,15] . Others have argued that variables correlating with the site of recurrence should include PSA timing [14] and PSA relapse characteristics such as PSA velocity (PSAV) [16] and PSA doubling time (PSADT) [17] .…”

Section: Discussionmentioning

confidence: 99%

Value of Immediate Anastomotic Biopsy following Biochemical Failure after Radical Prostatectomy

et al. 2008

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Aims: To study the value, in diagnostic terms, of performing transrectal ultrasound (TRUS)-guided anastomotic biopsy immediately following the diagnosis of biochemical failure in patients treated by radical retropubic prostatectomy. Methods: We report on 50 sessions of TRUS-guided biopsy obtained during post-radical retropubic prostatectomy follow-up, immediately after the diagnosis of biochemical failure. No patient had received either adjuvant or further treatment due to biochemical failure status prior to the biopsy session. In each case, tissue sampling involved cores taken by a standard protocol (random) as well as TRUS-guided biopsy to sonographically suspicious areas. Statistical analysis focused on identifying the statistical importance of various pre- and post-treatment variables in predicting biopsy outcome. Results: 10/50 cases with local evidence of malignancy (1 case harboring both benign and malignant glands) were identified and in another 10/50 cases benign prostatic tissue was diagnosed. The remaining (30) cases have shown fibromuscular tissue only. Statistical analysis of various parameters has demonstrated a significant correlation between local evidence of cancer and the finding of sonographically remarkable areas. Conclusion: Performing TRUS-guided anastomotic biopsy close to the onset of biochemical failure can frequently identify but also may easily miss the suspected local presence of prostate tissue. We believe that, with minimal risks of morbidity, there is merit in exploring its possibilities to trace local prostatic tissue, since it may provide useful information for further treatment actions also in an earlier time.

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Failure after radical prostatectomy

Cited by 27 publications

References 48 publications

Prognostic factors and reporting of prostate carcinoma in radical prostatectomy and pelvic lymphadenectomy specimens

Prognostic factors and reporting of prostate carcinoma in radical prostatectomy and pelvic lymphadenectomy specimens

Comparison of the prognostic potential of hyaluronic acid, hyaluronidase (HYAL‐1), CD44v6 and microvessel density for prostate cancer

Value of Immediate Anastomotic Biopsy following Biochemical Failure after Radical Prostatectomy

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