title: Radical prostatectomy for clinically localized prostate cancer: local tumor extension and prognosis.
abstract: BACKGROUND
  This study was performed to evaluate the frequency of local tumor extension and its effect on disease progression after radical prostatectomy.
  
  
  METHODS
  The study consisted of 66 consecutive men who underwent radical prostatectomy for clinically localized prostate cancer without any prior hormonal therapy. Cases were stratified according to pathologic findings. Sites of capsular penetration were also evaluated.
  
  
  RESULTS
  The overall incidences of lymph node metastases, seminal vesicle invasion, capsular penetration, and positive surgical margin were, respectively, 23%, 32%, 55% and 35%. The disease progression rate in patients with positive lymph nodes differed significantly from that in those without nodal metastases (P < 0.0001). Although seminal vesicle invasion, capsular penetration, or positive surgical margin had an adverse effect on prognosis, the difference in progression missed statistical significance, when patients with positive lymph node metastases were excluded. The most common site of capsular penetration was posterolateral, in the area of the neurovascular bundle.
  
  
  CONCLUSIONS
  Extraglandular tumor extension and positive surgical margins are common features of radical prostatectomy specimens. A nerve-sparing operation should be performed selectively and with great caution. The markedly adverse effect of lymph node involvement on progression must be accounted for when evaluating other variables relating to progression.
authors.affiliation: Department of Urolology, Kurashiki Central Hospital, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: H
authors.initials: H
authors.lastname: Kanamaru
authors.forename: S
authors.initials: S
authors.lastname: Moroi
authors.forename: S
authors.initials: S
authors.lastname: Ishitoya
authors.forename: K
authors.initials: K
authors.lastname: Okubo
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: O
authors.initials: O
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies