Extraprostatic extension ( EPE ) of prostatic carcinoma: is its proximity to the surgical margin or G leason score important?

Objective To examine the association between histopathological factors of extraprostatic prostate cancer and outcome. Patients and Methods Patients with extraprostatic extension ( EPE ) without positive margins, seminal vesicle or lymph node involvement were analysed from a consecutive radical prostatectomy cohort of 1136 (2002–2006) for: (i) distance of EPE from the margin; (ii) G leason score of the EPE ; and (iii) extent of EPE . Log‐rank, K aplan– M eier, and Cox regression analyses were performed. Results The study included 194 pT3a , pN0 , R0 patients with a median follow‐up of 5.4 years, with 37 (19%) patients experiencing biochemical relapse ( BCR ). On univariable analysis, patients with a G leason score of ≥8 in the extraprostatic portion showed increased incidence of BCR compared with those with Gleason scores of ≤7 ( P = 0.03). The proximity of the EPE to the margin (0.01–7.5 mm) did not correlate with BCR . On multivariable analysis, the extent of EPE , the G leason score of the dominant nodule or of the EPE portion did not correlate with BCR . Conclusion Data from this study using current International Society of Urological Pathology G leason scoring and EPE criteria indicate that close proximity of EPE to the margin is not associated with recurrence. G leason score ≥8 within EPE is associated with an increased BCR risk on univariable analysis, but larger studies are required to confirm whether extensive G leason pattern 4 in an EPE indicates increased risk in an otherwise overall G leason score 7 cancer.