Table 2

Summary of pathological findings of prostate specimens in patients with positive nodes in the anterior prostatic fat

PatientPreop biopsy histology (Gleason) and imaging for pelvic lymph nodesPreop PSA (ng/mL)Pathological tumour data TNM (2002)Margin and pelvic lymph node dissection (PLND) statusPostop outcome
1
62 years old
4+5=9–4/5 cores on the right (15%)
MRI negative for nodes
12pT2b, 4+5=9
predominantly right lobe but extending anteriorly 5.1 mL
Margins negative
PLND negative (APF 20×20×10 mm) 57 g gland
PSA nadir <0.01 ng/mL. Treated with 6 months of androgen deprivation therapy after surgery. PSA after 24 months of follow-up was <0.01 ng/mL
2
63 years old
4+3=7–2/6 cores on the right (<5%), 6/6 cores on the left (85%) with tertiary pattern 5 present
MRI negative for nodes
3.3pT3a, 4+5=9
predominantly left lobe but extending anteriorly 12.3 mL
Margins positive extraprostatic and apex
PLND negative (APF—60×50×5 mm) 67 g gland
PSA nadir was <0.1 ng/ml. Surveyed after surgery. PSA rose to 0.2 ng/mL at 8 months of follow-up, patient underwent salvage radiation but PSA continued to rise after. PSA 10.8 ng/mL after 26 months of follow-up, Patient has declined androgen deprivation therapy to date
3
65 years old
3+3=6–2/5 cores on the right (<1%), 4+3=7–3/6 cores on the left (25%)
MRI negative for nodes
9.7pT3a, 4+3=7
tumour predominantly left posterolateral but extending anteriorly 2.1 mL
Margins negative
PLND negative (APF—40×20×8 mm) 78 g gland
PSA nadir 2.0 ng/mL. Treated with androgen deprivation therapy after surgery. The PSA after 24 months of follow up is 0.2 ng/mL
4
65 years old
3+3=6–1/5 cores on the right (2%), 1/6 cores on the left (5%)
MRI not performed
10.2pT3b, 5+4=9
tumour predominantly left posterolateral but extending anteriorly 9.0 mL
Margins positive extraprostatic, apex and base
PLND not performed (APF 40×20×5 mm) 45 g gland
PSA nadir 8.0 ng/mL and rose rapidly after surgery. Bone scan demonstrated bone metastases. Androgen deprivation therapy commenced. PSA after 24 months of follow-up is <0.1 ng/mL
  • APF, anterior prostatic fat; PSA, prostrate specific antigen; TNM, tumour nodes metastasis.