All surgical specimens were examined in detail for certain pathologic features including presence of
extraprostatic invasion, perineural invasion, positive surgical margin, seminal vesicle invasion and Gleason score.
Oligometastatic disease was defined as 1-5
extraprostatic lesions (<= 3 lesions in any single organ system) in men with negative prostate/bed imaging (as a surrogate for primary tumor control).
Other studies have also shown that even
extraprostatic extension in GS 6 prostate cancers is uncommon and seminal vesicle invasion is exceptional.
It is a predictor of
extraprostatic tissue extention of the tumor or ultimately recurrence of the tumor.
Embolization commenced at the distal
extraprostatic part of the PA, and after advancement of the microcatheter beyond the potential origin of collateral branches to the bladder, rectum, or penis.
In a study by Lobel and Rodriquez (15), pathogenic microorganisms related to possible prostatitis were separated into five categories and identified as: (1) prostate pathogens that are commonly accepted, including Gram-negative bacteria: Enterobacteriaceae (e.g., Escherichia, Klebsiella, and Pseudomonas); (2) possible prostate pathogens, including Gram-positive bacteria (e.g., Enterococcus and Staphylococcus); (3) possible prostate pathogens, such as coagulase-negative Staphylococcus, Chlamydia, Mycoplasma, anaerobic bacteria, yeast (Candida), and Trichomonas; (4) commonly known
extraprostatic pathogens, such as Lactobacillus and Corynebacterium; and (5) biofilms, viruses, and cell wall deficient bacteria which cannot be reproduced in cultures.
In the intermediate-risk group, the rate of
extraprostatic invasion was significantly higher as surgical delay increased (p=0.044).
Black patients were more likely to have
extraprostatic disease clinically.
On the other hand, in the case of reliable preoperative T3 disease findings, more radical surgical procedures can be planned, including extensive pelvic lymphadenectomy and avoiding nerve-sparing technique (at least on the side of the
extraprostatic spread).
The predictive value of endorectal 3 Tesla multiparametric magnetic resonance imaging for
extraprostatic extension in patients with low, intermediate and high risk prostate cancer.
There was no
extraprostatic, perineural, lymphatic, or vascular spread.
The pathology analyses were performed by pathologists with extensive experience in urooncology and were in all cases reviewed by an experienced uropathologist, although according to the literature, the variation between observers regarding the surgical margin and
extraprostatic extension tends to be small.