The impact of histopathological analysis of anterior peri-prostatic fat in radical prostatectomy patients
Author(s)
Filby, Joseph
Nesbitt, Alexander L
Ravichandran, Kapilan
Antoniou, Stefan
Smith, Philip G
Evans, Garrath A
Shepherd, Benjamin
Pridgeon, Simon W
Griffith University Author(s)
Year published
2020
Metadata
Show full item recordAbstract
Objective:
To determine the usefulness of histopathological analysis of peri-prostatic fat in a cohort of prostate cancer patients undergoing radical prostatectomy (RP) in an Australian regional centre. During RP, removal of the anterior peri-prostatic fat (APPF) is commonly undertaken; some surgeons routinely request histopathological analysis of this specimen. Previously published data show positive cancer detection in peri-prostatic fat in 0–2.5% of specimens and positive yields are mostly detected in patients with adverse pathological features.
Subjects and methods:
All patients undergoing RP in a regional urology unit ...
View more >Objective: To determine the usefulness of histopathological analysis of peri-prostatic fat in a cohort of prostate cancer patients undergoing radical prostatectomy (RP) in an Australian regional centre. During RP, removal of the anterior peri-prostatic fat (APPF) is commonly undertaken; some surgeons routinely request histopathological analysis of this specimen. Previously published data show positive cancer detection in peri-prostatic fat in 0–2.5% of specimens and positive yields are mostly detected in patients with adverse pathological features. Subjects and methods: All patients undergoing RP in a regional urology unit in Queensland were identified. Pathology results were examined retrospectively to determine the rate of cancer involvement in APPF specimens and medical records were reviewed to assess any clinical impact. Results: APPF was sent for pathological analysis in 270/298 (90%) of patients undergoing RP. Prostate cancer was detected in one sample containing a single involved lymph node in a patient with Gleason 5 + 4 = 9 prostate cancer and pathological stage pT3bN1R1Mx. The presence of the cancer in the APPF did not affect the decision to offer adjuvant radiotherapy. Conclusion: In our population, we have identified a positive cancer yield of 0.3% in APPF specimens. When combined with all previously published series, we found positive cancer detection in 72/7391 (1%) specimens, and most patients with positive fat involvement had adverse pre-operative and final pathological features. Surgeons may consider omitting sending APPF specimens for analysis based on the low yield with little additional staging information. If surgeons continue this practice, they should consider selectively requesting analysis in intermediate- and high-risk patients.
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View more >Objective: To determine the usefulness of histopathological analysis of peri-prostatic fat in a cohort of prostate cancer patients undergoing radical prostatectomy (RP) in an Australian regional centre. During RP, removal of the anterior peri-prostatic fat (APPF) is commonly undertaken; some surgeons routinely request histopathological analysis of this specimen. Previously published data show positive cancer detection in peri-prostatic fat in 0–2.5% of specimens and positive yields are mostly detected in patients with adverse pathological features. Subjects and methods: All patients undergoing RP in a regional urology unit in Queensland were identified. Pathology results were examined retrospectively to determine the rate of cancer involvement in APPF specimens and medical records were reviewed to assess any clinical impact. Results: APPF was sent for pathological analysis in 270/298 (90%) of patients undergoing RP. Prostate cancer was detected in one sample containing a single involved lymph node in a patient with Gleason 5 + 4 = 9 prostate cancer and pathological stage pT3bN1R1Mx. The presence of the cancer in the APPF did not affect the decision to offer adjuvant radiotherapy. Conclusion: In our population, we have identified a positive cancer yield of 0.3% in APPF specimens. When combined with all previously published series, we found positive cancer detection in 72/7391 (1%) specimens, and most patients with positive fat involvement had adverse pre-operative and final pathological features. Surgeons may consider omitting sending APPF specimens for analysis based on the low yield with little additional staging information. If surgeons continue this practice, they should consider selectively requesting analysis in intermediate- and high-risk patients.
View less >
Journal Title
Journal of Clinical Urology
Note
This publication has been entered into Griffith Research Online as an Advanced Online Version.
Subject
Clinical sciences