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“The Radial Distance of Extraprostatic Extension of Prostate Carcinoma”
Brian J. Davis. M.D., PHD, Thomas M. Pisansky, M.D., Torrence M. Wilson, MD, Harold J. Rothenberg, M.D., Anna Pacelli, M.D., David W. Hillman, MS, Daniel J. Sargent, PHD, and David G. Bostwick, M.D. Cancer, Vol. 85, No. 12, 1999
When determining an acceptable treatment for localized prostate cancer, extaprostatic extension is important. Certain procedures are conducted based on the extraprostatic extension of prostate carcinoma. If the cancer has not extended 5mm beyond the main cancerous region, many physicians will commonly recommend brachytherapy treatment. Advantages for prostate brachytherapy patients include a minimally invasive, cost efficient surgery and speedy outpatient recovery. For the purpose of this study, doctors both defined and evaluated a widespread measure of prostate cancer that has extended in a large group of radical prostatectomy specimens. The results of this study reveal that brachytherapy may prove to be a legitimate method in cancer management. Researchers focused on 376 radical retropubic prostatectomy patients that underwent surgery between September 1991 and June 1993. Each patient was evaluated based on whole mount radical retropubic prostatectomy specimens, otherwise known as a microscopic examination where the whole specimen is placed on the slide. Doctors also reviewed the location of the extraprostatic extension (or the extended prostate cancer), and its distance perpendicular to the edge of the prostate. Once physicians analyzed whole mount specimens, the location and distance of the extended cancer, results could be calculated. This study found that 105 of 376 specimens, 28 percent were identified at 248 sites. The average distance ranged from .03mm to .8mm. Out of the 105 patients included in the trial, general PSA levels ranged from 11.8 ng/mL to 17.9 ng/mL, Gleason scores were approximately 6.3, and prostate volume was normally 39cc. What influences treatment strategies for patients with localized cancer is the radial distance, (or the measurement from a central point outward), of any noted extraprostatic extension of prostate cancer. From this study it was determined that doctors could manage extension with brachytherapy. Brachytherapy in conjunction with prostatectomy could treat all known disease in 99%-100% of specimens with extended prostate cancer and in 99.5%-100% of all specimens examined. The radiation dose administered during brachytherapy provides an effective coverage of extended prostate
tumors.
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