The radial distance of extraprostatic extension of prostatic adenocarcinoma: Implications for prostate brachytherapy

Davis, Brian J.; Pisansky, Thomas M.; Myers, Robert P.; Rothenberg, Harold J.; Pacelli, Anna; Hillman, David W.; Sargent, Daniel J.; Bostwick, David G.

doi:10.1016/s0360-3016(98)80116-8

Cited by 7 publications

(6 citation statements)

References 36 publications

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“…Appropriate clinical target volume (CTV) should cover the area at risk of microscopic disease spread for these patients. Pathological evaluations provided guidance for CTV definition when there was an extracapsular extension or seminal vesicle invasion [19][20][21][22]. A retrospective review by Chao et al found that more than 20% of patients with PSA >10 or biopsy GS > = 7 had an extracapsular extension extending beyond 4 to 5 mm [19].…”

Section: Discussionmentioning

confidence: 99%

“…Pathological evaluations provided guidance for CTV definition when there was an extracapsular extension or seminal vesicle invasion [19][20][21][22]. A retrospective review by Chao et al found that more than 20% of patients with PSA >10 or biopsy GS > = 7 had an extracapsular extension extending beyond 4 to 5 mm [19]. When there was disease involvement in the seminal vesicle, 10% of cases had disease extending beyond the proximal 2 cm [22].…”

Section: Discussionmentioning

confidence: 99%

“…Recent technology improvement in treatment planning and delivery with image guidance and intensity-modulated RT has improved treatment precision by reducing the treatment margins, therefore limiting radiation dose to surrounding normal tissues. However, the reduction of margins without considering the pattern and extent of the microscopic spread of disease may negatively influence outcomes [19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Risk of adverse pathological features for intermediate risk prostate cancer: Clinical implications for definitive radiation therapy

et al. 2021

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Background Intermediate risk prostate cancer represents a largely heterogeneous group with diverse disease extent. We sought to establish rates of adverse pathological features important for radiation planning by analyzing surgical specimens from men with intermediate risk prostate cancer who underwent immediate radical prostatectomy, and to define clinical pathologic features that may predict adverse outcomes. Materials and methods A total of 1552 men diagnosed with intermediate risk prostate cancer who underwent immediate radical prostatectomy between 1/1/2005 and 12/31/2015 were reviewed. Inclusion criteria included available preoperative PSA level, pathology reports of transrectal ultrasound-guided prostate biopsy, and radical prostatectomy. Incidences of various pathological adverse features were evaluated. Patient characteristics and clinical disease features were analyzed for their predictive values. Results Fifty percent of men with high risk features (defined as PSA >10 but <20 or biopsy primary Gleason pattern of 4) had pathological upstage to T3 or higher disease. The incidence of upgrade to Gleason score of 8 or higher and the incidence of lymph node positive disease was low. Biopsy primary Gleason pattern of 4, and PSA greater than 10 but less than 20, affected adverse pathology in addition to age and percent positive biopsy cores. Older age and increased percentage of positive cores were significant risk factors of adverse pathology. Conclusion Our findings underscore the importance of comprehensive staging beyond PSA level, prostate biopsy, and CT/bone scan for men with intermediate risk prostate cancer proceeding with radiation in the era of highly conformal treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk of adverse pathological features for intermediate risk prostate cancer: Clinical implications for definitive radiation therapy

et al. 2021

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“…19 Nonetheless, a recent study from Davis et al, examined prostate specimens from patients with clinical T1c disease undergoing radical prostatectomy and was able to determine that pathologic focal extracapsular disease was within 3.3 mm of the prostate capsule over 90% of the time and that the maximum distance of disease was 1.2 cm. 20 With modern transperineal brachytherapy techniques, the dosimetry will usually encompass an extra prostatic margin that may cover and treat this area of extracapsular risk.…”

Section: Discussionmentioning

confidence: 99%

The role of external radiotherapy in patients treated with permanent prostate brachytherapy

Potters

Fearn

Kattan

2002

Prostate Cancer Prostatic Dis

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“…All plans met in-house dose constraints (Table 1) similar to those outlined by Stock et al [32,33,34]. While planning, a target structure is created which encompasses the prostate volume plus a 3mm margin for potential microscopic spread [35]. Plans are optimized to target coverage but dose to the prostate is considered.…”

Section: Treatment Techniquementioning

confidence: 99%

Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy

Martell

Roy

Meyer

et al. 2020

Heliyon

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To compare the outcomes of patients with intermediate risk prostate cancer (IR-PCa) treated with lowdose rate I-125 seed brachytherapy (LDR-BT) and targeted dose painting of a histologic dominant intra-epithelial lesion (DIL) to those without a DIL. Methods: 455 patients with IR-PCa were treated at a single center with intra-operatively planned LDR-BT, each following the same in-house dose constraints. Patients with a DIL on pathology had hot spots localized to that region but no specific contouring during the procedure. Results: 396 (87%) patients had a DIL. Baseline tumor characteristics and overall prostate dosimetry were similar between patients with and without DIL except the median number of biopsy cores taken: 10 (10-12) vs 12 (10-12) (p ¼ 0.002). 19 (5%) and 18 (5%) of patients with and 1 (2%) and 0 (0%) of those without DIL experienced CTCAE grade 2 and 3 toxicity respectively. Overall, toxicity grade did not significantly correlate with presence of DIL (p ¼ 0.10). Estimated 7-year freedom from biochemical failure (FFBF) was 84% (95% confidence interval: 79-89) and 70% (54-89) in patients with and without a DIL (log-rank p ¼ 0.315). In DIL patients, cox regression revealed location of DIL ("Base" vs "Apex" HR: 1.03; 1.00-1.06; p ¼ 0.03) and older age (70 vs 60 HR: 1.62; 1.06-2.49; p ¼ 0.03) was associated with poor FFBF. Conclusions: Targeting DIL through dose painting during intraoperatively planned LDR-BT provided no statistically significant change in FFBF. Patients with DILs in the prostate base had slightly lower FFBF despite DIL boost.

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The radial distance of extraprostatic extension of prostatic adenocarcinoma: Implications for prostate brachytherapy

Cited by 7 publications

References 36 publications

Risk of adverse pathological features for intermediate risk prostate cancer: Clinical implications for definitive radiation therapy

Risk of adverse pathological features for intermediate risk prostate cancer: Clinical implications for definitive radiation therapy

The role of external radiotherapy in patients treated with permanent prostate brachytherapy

Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy

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