{"id":2125,"date":"2022-12-06T20:08:02","date_gmt":"2022-12-06T20:08:02","guid":{"rendered":"https:\/\/dev.isupweb.org\/isup\/?post_type=journal-club&p=2125"},"modified":"2022-12-06T23:57:45","modified_gmt":"2022-12-06T23:57:45","slug":"fourth-quarter-of-2022","status":"publish","type":"journal-club","link":"https:\/\/dev.isupweb.org\/isup\/blog\/journal-club\/fourth-quarter-of-2022\/","title":{"rendered":"FOURTH QUARTER OF 2022"},"content":{"rendered":"\n

The Clinical Significance of Either Extraprostatic Extension or Microscopic Bladder Neck Invasion Alone Versus Both in Men With pT3a Prostate Cancer Undergoing Radical Prostatectomy: A Proposal for a New pT3a Subclassification<\/strong>
\nTeramoto, Yuki; Numbere, Numbereye; Wang, Ying; More
\nFREE LINK
\nThe Clinical Significance of Either Extraprostatic Extension or Microscopic Bladder Neck Invasion Alone Versus Both in Men With pT3a Prostate Cancer Undergoing Radical Prostatectomy: A Proposal for a New pT3a Subclassification<\/a>
\n<\/a>
\nThe American Journal of Surgical Pathology. 46(12):1682-1687, December 2022.
\nPrécis
\nThe authors conducted retrospective study, that included review of large volume prostatectomies with pT3a stage (n=957) with follow up data collection for assessment of prognostic significance of extraprostatic extension (EPE) and its extent, bladder neck invasion (mBNI) and simultaneous presence of both EPE and mBNI. The results showed that presence of EPE together with mBNI was associated with worse outcomes than EPE or mBNI alone. Based on aforementioned findings authors propose subclassification of the current AJCC pT3a stage into 3-tier subclassification: pT3a1 (focal EPE or mBNI alone), pT3a2 (extensive EPE alone), and pT3a3 (both EPE and mBNI); or 2-tier subclassification: pT3a1 (either EPE or mBNI) and pT3a2 (both EPE and mBNI).<\/p>\n

Comment
\nThe finding of worse outcomes in patients with both EPE and mBNI is new significant data that will potentially improve risk stratification of prostate cancer patients. Spreading the knowledge about this finding may be beneficial to broad audience of both clinicians and pathologists. However, high interobserver variability and lack of widely accepted standardized morphologic criteria for presence of EPE or mBNI and quantifying the EPE extent poses the problem. Comparison of prognostic impact of mBNI and focal EPE with pT2 stage prostate cancer might have added to the value of this study. It would be prudent to validate the finding of this study in different institutions as the reporting practice may differ significantly among the pathologists. As synoptic reporting templates are widespread and already include all aforementioned findings, the clinical significance of proposal to further subdivide pT3a, that is already a substage, is unclear and may go against the AJCC classification style used in other organs.<\/p>\n

Reviewed by: Oleksandr Kravtsov, MD<\/p>\n<\/body><\/html>\n","protected":false},"excerpt":{"rendered":"

The Clinical Significance of Either Extraprostatic Extension or Microscopic Bladder Neck Invasion Alone Versus Both in Men With pT3a Prostate Cancer Undergoing Radical Prostatectomy: A Proposal for a New pT3a Subclassification Teramoto, Yuki; Numbere, Numbereye; Wang, Ying; More FREE LINK The Clinical Significance of Either Extraprostatic Extension or Microscopic Bladder Neck Invasion Alone Versus Both … Continue reading FOURTH QUARTER OF 2022<\/span> →<\/span><\/a><\/p>\n","protected":false},"featured_media":0,"parent":0,"menu_order":0,"template":"","class_list":["post-2125","journal-club","type-journal-club","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dev.isupweb.org\/isup\/wp-json\/wp\/v2\/journal-club\/2125"}],"collection":[{"href":"https:\/\/dev.isupweb.org\/isup\/wp-json\/wp\/v2\/journal-club"}],"about":[{"href":"https:\/\/dev.isupweb.org\/isup\/wp-json\/wp\/v2\/types\/journal-club"}],"wp:attachment":[{"href":"https:\/\/dev.isupweb.org\/isup\/wp-json\/wp\/v2\/media?parent=2125"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}