Fast Five Quiz: Advanced and Metastatic Prostate Cancer Treatment

Daniel S. Schwartz, MD, MBA


May 02, 2022

Figure 1. Prostate cancer cells.

According to the recommendations from the 2017 Advanced Prostate Cancer Consensus Conference (APCCC), extracapsular nodal extension, the total number of nodes with metastases, and the tumor volume within the lymph node are important prognostic measures in men with locally advanced prostate cancer.

The APCCC recommends that pathology reporting for radical prostatectomies should adhere to the American Joint Committee on Cancer's AJCC Cancer Staging Manual, Eighth Edition. Recent updates include the adoption of prognostic Gleason grade groups along with Gleason scores, the collapsing of pathologic classification pT2 tumors to one single group, and the use of elevated prostate-specific antigen (PSA) level to increase clinical staging. International Society of Urological Pathology guidelines should be used to comment on tumor Gleason scores.

Gleason score reporting is not indicated for patients who have previously been treated with either ADT and/or other systemic treatment or radiation therapy (RT).

Both the European Association of Urology and National Comprehensive Cancer Network (NCCN) guidelines recommend performing extended pelvic lymph node dissection in men with high-risk and locally advanced prostate cancer, especially when the risk for lymph node metastases based on available nomograms is estimated to be ≥ 5%.

Learn more about the pathology and prognosis of advanced and metastatic prostate cancer.


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