When Cancer Extends Beyond the Prostate
At the time of radical prostatectomy, some men are found to have what’s called “extraprostatic extension,” or EPE — cancer that extends slightly beyond the prostate. A new study shows that for the vast majority of men, this does not increase the risk of dying from prostate cancer. “Overall, these men have a better prognosis following surgery compared to men with prostate cancer invasion into the seminal vesicle or lymph node involvement,” says urologist Misop Han, M.D. “However, their clinical course following surgery is variable, so that it is challenging to give advice to these men about additional therapy.”
Using the large radical prostatectomy database at Johns Hopkins, Han, Associate Professor of Urology and Oncology, and pathologist Jonathan Epstein, M.D. the Reinhard Professor of Urologic Pathology, recently studied whether the extent of EPE affects the long-term outcome after surgery. They found that men with a small amount of EPE are less likely to experience recurrence following surgery compared to those with a larger amount of EPE. “Fortunately,” says Han, “the chance of dying from prostate cancer in men with EPE was very small regardless of the extent.” However, based on these results, Han and Epstein concluded that men with a larger amount of EPE are at increased risk for recurrence and should consider additional therapy following surgery. The study’s results were published in European Urology.
“Fortunately, the chance of dying from prostate cancer in men with EPE was very small regardless of the extent.”