What does Extraprostatic extension mean?
Extraprostatic extension (EPE) on histopathological examination refers to the identification of tumor cells beyond the borders of the prostate, most often recognized as tumor intermingling with periprostatic adipose tissue.
Why do you have radiation after prostate removal?
The goal of adjuvant post-prostatectomy radiation therapy is to reduce the risk or eliminate a recurrence of cancer in the prostate bed. In the second situation where IMRT is given after a prostatectomy, usually months or years have passed since the surgery before evidence of a recurrence in the prostate bed develops.
What is a good PSA number 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.
Is radiation necessary after radical prostatectomy?
Radiotherapy (RT) immediately after RP may potentially eradicate any residual localized microscopic disease in the prostate bed, and it is associated with improved biochemical, clinical progression-free survival, and overall survival in patients with high-risk pathological features according to published randomized …
Why does PSA go up after prostatectomy?
This usually happens when the tumor is advanced at the time of surgery and could have already spread its cancer cells to other parts of the body. It is considered elevated PSA after prostatectomy a PSA greater than 0.2 ng/ml.
How long does it take for the prostate to heal after radiation?
They gradually get worse during the treatment and for a couple of weeks after the treatment ends. But they usually begin to improve after around 2 weeks or so.
Is radiation after prostatectomy successful?
Adjuvant radiation for patients with positive margins after prostatectomy decreases local recurrence; no difference in overall survival – Mayo Clinic.
Does prostate surgery extend life?
After 23 years the men treated with radical prostatectomy gained a mean of 2.9 extra years of life. The researchers found that the absolute benefit associated with radical prostatectomy increased by a factor of more than two from 10 to 23 years’ follow-up in terms of overall mortality and disease specific mortality.
What does extraprostatic extension mean in prostate cancer?
Extraprostatic Extension Indicates Aggressive Prostate Cancer. Many patients with extraprostatic extension on biopsy experience biochemical recurrence after surgery and require early multi-modal therapy.
When is adjuvant radiation indicated for men with extraprostatic extension?
Patrick Walsh and Nathan Laurentschuk have just published an opinion piece in European Urology taking issue with the 2013 AUA/ASTRO recommendation that adjuvant radiation is indicated for men with a pathological finding of extraprostatic extension (EPE, stage pT3a) after surgery, regardless of the surgical margin status.
What are the diagnostic criteria for extraprostatic extension?
broad capsular contact (≥10-20 mm in a curvilinear length of contact between tumor and capsule) 1,5-7 Independent of these morphological criteria, the risk of extraprostatic extension also correlates with the PI-RADSassessment category on multiparametric MRI (mpMRI) 9.
What are the morphologic predictors of extraprostatic extension at MRI?
Morphologic predictors of extraprostatic extension at MRI are listed in rough order from most specific to most sensitive 1,3,4: seminal vesicle invasion(asymmetric loss of normal high T2 signal in the seminal vesicular lumen) neurovascular asymmetry (unequal appearance of neurovascular bundles when an ipsilateral tumor is present)