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Difference between revisions of "Prostate cancer staging"
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| T4 | | T4 | ||
| extension into a surrounding anatomical structure, e.g. [[urinary bladder | | extension into a surrounding anatomical structure, e.g. [[urinary bladder]] | ||
| bladder neck invasion is T3b | | bladder neck invasion is T3b | ||
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#Malignant cells directly adjacent to peri-prostatic adipose tissue. | #Malignant cells directly adjacent to peri-prostatic adipose tissue. | ||
Notes: | |||
*The apex of the prostate gland may have some skeletal muscle. Thus, it is difficult to define extension at this site. EPE is not called at the apex by some pathologists; however, it is generally believed to exist.<ref name=pmid20802467/> | *The apex of the prostate gland may have some skeletal muscle. Thus, it is difficult to define extension at this site. EPE is not called at the apex by some pathologists; however, it is generally believed to exist.<ref name=pmid20802467/> | ||
*The anterior prostate has fibromuscular stroma that is difficult to separate from the extraprostatic tissue.<ref name=pmid18049129>{{cite journal |authors=Fine SW, Al-Ahmadie HA, Gopalan A, Tickoo SK, Scardino PT, Reuter VE |title=Anatomy of the anterior prostate and extraprostatic space: a contemporary surgical pathology analysis |journal=Adv Anat Pathol |volume=14 |issue=6 |pages=401–7 |date=November 2007 |pmid=18049129 |doi=10.1097/PAP.0b013e3181597a9c |url=}}</ref> | |||
**Anterior fibromuscular stroma (AFMS) versus extraprostatic extension (EPE): true EPE is proposed to be into the fat ''or'' thick rounded muscle bundles.<ref name=pmid18049129/> | |||
=====Prostate biopsy===== | =====Prostate biopsy===== | ||
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*Bladder neck invasion is '''pT3a'''.<ref name=pmid23225909>{{Cite journal | last1 = Chung | first1 = MS. | last2 = Lee | first2 = SH. | last3 = Lee | first3 = DH. | last4 = Chung | first4 = BH. | title = Evaluation of the 7th American Joint Committee on cancer TNM staging system for prostate cancer in point of classification of bladder neck invasion. | journal = Jpn J Clin Oncol | volume = 43 | issue = 2 | pages = 184-8 | month = Feb | year = 2013 | doi = 10.1093/jjco/hys196 | PMID = 23225909 }}</ref> | *Bladder neck invasion is '''pT3a'''.<ref name=pmid23225909>{{Cite journal | last1 = Chung | first1 = MS. | last2 = Lee | first2 = SH. | last3 = Lee | first3 = DH. | last4 = Chung | first4 = BH. | title = Evaluation of the 7th American Joint Committee on cancer TNM staging system for prostate cancer in point of classification of bladder neck invasion. | journal = Jpn J Clin Oncol | volume = 43 | issue = 2 | pages = 184-8 | month = Feb | year = 2013 | doi = 10.1093/jjco/hys196 | PMID = 23225909 }}</ref> | ||
*Seen in approximately 1% of prostatectomies.<ref name=pmid19914651>{{Cite journal | last1 = Pierorazio | first1 = PM. | last2 = Epstein | first2 = JI. | last3 = Humphreys | first3 = E. | last4 = Han | first4 = M. | last5 = Walsh | first5 = PC. | last6 = Partin | first6 = AW. | title = The significance of a positive bladder neck margin after radical prostatectomy: the American Joint Committee on Cancer Pathological Stage T4 designation is not warranted. | journal = J Urol | volume = 183 | issue = 1 | pages = 151-7 | month = Jan | year = 2010 | doi = 10.1016/j.juro.2009.08.138 | PMID = 19914651 }}</ref> | *Seen in approximately 1% of prostatectomies.<ref name=pmid19914651>{{Cite journal | last1 = Pierorazio | first1 = PM. | last2 = Epstein | first2 = JI. | last3 = Humphreys | first3 = E. | last4 = Han | first4 = M. | last5 = Walsh | first5 = PC. | last6 = Partin | first6 = AW. | title = The significance of a positive bladder neck margin after radical prostatectomy: the American Joint Committee on Cancer Pathological Stage T4 designation is not warranted. | journal = J Urol | volume = 183 | issue = 1 | pages = 151-7 | month = Jan | year = 2010 | doi = 10.1016/j.juro.2009.08.138 | PMID = 19914651 }}</ref> | ||
*Bladder neck involvement can be seen without extraprostatic extension.<ref name=pmid15378493>{{Cite journal | last1 = Poulos | first1 = CK. | last2 = Koch | first2 = MO. | last3 = Eble | first3 = JN. | last4 = Daggy | first4 = JK. | last5 = Cheng | first5 = L. | title = Bladder neck invasion is an independent predictor of prostate-specific antigen recurrence. | journal = Cancer | volume = 101 | issue = 7 | pages = 1563-8 | month = Oct | year = 2004 | doi = 10.1002/cncr.20551 | PMID = 15378493 }}</ref> | |||
======Image====== | ======Image====== | ||
<gallery> | <gallery> | ||