Preparación y manejo de especímenes en prostatectomía radical: revisión de la literatura y recomendaciones actuales
DOI:
https://doi.org/10.35509/01239015.813Palabras clave:
Prostate cancer, prostatectomy, specimen handling, pathology, Gleason score.Resumen
La prostatectomía radical es el manejo quirúrgico estándar para los pacientes con cáncer de próstata localizado. Una vez realizado este procedimiento, todas las muestras de tejido obtenidas (próstata, vesículas seminales y ganglios linfáticos) son llevadas a análisis histopatológico. El resultado del informe patológico es la piedra angular
del tratamiento oncológico, ya que determinará el requerimiento de tratamientos adyuvantes; así como las tasas de supervivencia libre de recurrencia bioquímica, supervivencia cáncer específica y global. Dada la importancia clínica de procesar adecuadamente los especímenes y generar un informe de patología adecuado, existen múltiples guías de manejo que intentan resumir la forma de manejar y reportar los especímenes
de prostatectomía radical (4-10); sin embargo, la literatura reciente pone en consideración detalles adicionales del
procesamiento de las muestras y del reporte de los hallazgos que repercuten de forma significativa en los desenlaces oncológicos (por ejemplo: marcación y tinción de la próstata, características de márgenes positivos, extensión extraprostática focal, subclasificación pT2, concepto pT2+, características de los ganglios linfáticos, entre otros). En Colombia no existe un consenso acerca de cual de las guías internacionales se adapta más a las características de nuestro medio; además, los detalles que se vienen mencionado en la literatura reciente no son tenidos en cuenta de forma sistemática en los informes locales.
Referencias bibliográficas
1. Tao Z-Q, Shi A-M, Wang K-X, Zhang W-D. Epidemiology of prostate cancer: current status. Eur Rev Med Pharmacol Sci. 2015;19(5):805–12.
2. Ministerio de la Protección Social. Guía de práctica clínica ( GPC ) para la detección temprana , seguimiento y rehabilitación del cáncer de próstata. 2013.
3. Samaratunga H, Montironi R, True L, Epstein JI, Griffiths DF, Humphrey PA, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 1: Specimen handling. Mod Pathol [Internet]. 2011;24(1):6–15. Available from: http://dx.doi.org/10.1038/modpathol.2010.178
4. Srigley JR, Humphrey PA, Amin MB, Chang SS, Egevad L, Epstein JI, et al. Protocol for the examination of specimens from patients with carcinoma of the prostate gland. Arch Pathol Lab Med. 2020;133(10):1568–76.
5. (ICCR) IC on CR. Prostate Cancer Histopathology Reporting Guide Radical Prostatectomy Specimen. 2017;(August):1–2.
6. Sewell C. Standards and Datasets for Reporting Cancers Dataset for histopathology reports for prostatic carcinoma. R Coll Pathol. 2016;(261035):1–31.
7. Dash A, Maine IP, Varambally S, Shen R, Chinnaiyan AM, Rubin MA. Changes in differential gene expression because of warm ischemia time of radical prostatectomy specimens. Am J Pathol. 2002;161(5):1743–8.
8. Best S, Sawers Y, Fu VX, Almassi N, Huang W, Jarrard DF. Integrity of Prostatic Tissue for Molecular Analysis After Robotic-Assisted Laparoscopic and Open Prostatectomy. Urology. 2007;70(2):328–32.
9. Egevad L. Handling of radical prostatectomy specimens. Histopathology. 2012;60(1):118–24.
10. Start RD, Layton CM, Cross SS, Smith JHF. Reassessment of the rate of fixative diffusion. J Clin Pathol. 1992;45(12):1120–1.
11. Harvey CJ, Pilcher J, Richenberg J, Patel U, Frauscher F. Applications of transrectal ultrasound in prostate cancer. Br J Radiol. 2012;85(SPEC. ISSUE 1):3–17.
12. Cohen MB, Soloway MS, Murphy WM. Sampling of radical prostatectomy specimens: How much is adequate? Am J Clin Pathol. 1994;101(3):250–2.
13. Duffield AS, Epstein JI. Detection of cancer in radical prostatectomy specimens with no residual carcinoma in the initial review of slides. Am J Surg Pathol. 2009;33(1):120–5.
14. Gleason D. Classification of prostatic carcinomas. Cancer Chemother reports. 1966;50(3):125–8.
15. Epstein JI, Amin MB, Reuter VE, Humphrey PA. Contemporary gleason grading of prostatic carcinoma. Am J Surg Pathol. 2017;41(4):e1–7.
16. Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. The 2014 international society of urological pathology (ISUP) consensus conference on gleason grading of prostatic carcinoma definition of grading patterns and proposal for a new grading system. Am J Surg Pathol. 2016;40(2):244–52.
17. Trock BJ, Guo CC, Gonzalgo ML, Magheli A, Loeb S, Epstein JI. Tertiary Gleason Patterns and Biochemical Recurrence After Prostatectomy: Proposal for a Modified Gleason Scoring System. 2015;182(4):1364–70.
18. Pierorazio PM, Walsh PC, Partin AW, Epstein JI. Prognostic Gleason grade grouping: Data based on the modified Gleason scoring system. BJU Int. 2013;111(5):753–60.
19. Chirag Doshi, Michael Vacchio, Kristopher Attwood, Christine Murekeyisoni, Diana C. Mehedint, Shervin Badkhshan1, Gissou Azabdaftari, Norbert Sule, Khurshid A. Guru, James L. Mohler and ECK. Clinical Significance of Prospectively Assigned Gleason Tertiary Pattern 4 in Contemporary Gleason Score 3+3 =6 Prostate Cancer. Prostate. 2017;76(8):715–21.
20. Epstein JI, Matoso A. Survival Guide to Prostate Pathology. 1st ed. Innovative Science Press; 2020. 145–177 p.
21. Sobin LH, Fleming ID. TNM classification of malignant tumors, Fifth edition (1997). Cancer. 1997;80(9):1803–4.
22. L.H. Sobin, M.K. Gospodarowicz CW. TNM Classification of Malignant Tumours. 2009. 368 p.
23. Van Der Kwast TH, Amin MB, Billis A, Epstein JI, Griffiths D, Humphrey PA, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 2: T2 substaging and prostate cancer volume. Mod Pathol [Internet]. 2011;24(1):16–25. Available from: http://dx.doi.org/10.1038/modpathol.2010.156
24. Paner GP, Stadler WM, Hansel DE, Montironi R, Lin DW, Amin MB. Updates in the Eighth Edition of the Tumor-Node-Metastasis Staging Classification for Urologic Cancers. Eur Urol [Internet]. 2018;73(4):560–9. Available from: http://dx.doi.org/10.1016/j.eururo.2017.12.018
25. Stamey TA, McNeal JE, Yemoto CM, Sigal BM, Johnstone IM. Biological determinants of cancer progression in men with prostate cancer. J Am Med Assoc. 1999;281(15):1395–400.
26. Sakai I, Harada KI, Kurahashi T, Yamanaka K, Hara I, Miyake H. Analysis of differences in clinicopathological features between prostate cancers located in the transition and peripheral zones. Int J Urol. 2006;13(4):368–72.
27. Sakai I, Harada KI, Hara I, Eto H, Miyake H. A comparison of the biological features between prostate cancers arising in the transition and peripheral zones. BJU Int. 2005;96(4):528–32.
28. Magi-Galluzzi C, Evans AJ, Delahunt B, Epstein JI, Griffiths DF, Van Der Kwast TH, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 3: Extraprostatic extension, lymphovascular invasion and locally advanced disease. Mod Pathol [Internet]. 2011;24(1):26–38. Available from: http://dx.doi.org/10.1038/modpathol.2010.158
29. Epstein JI, Carmichael M, Partin AW, Walsh PC. Is tumor volume an independent predictor of progression following radical prostatectomy? A multivariate analysis of 185 clinical stage B adenocarcinomas of the prostate with 5 years of followup. J Urol. 1993;149(6):1478–81.
30. Epstein JI. Pathologic assessment of the surgical specimen. Urol Clin North Am. 2001;28(3):567–94.
31. Wheeler TM, Dillioglugil Ö, Kattan MW, Arakawa A, Soh S, Suyama K, et al. Clinical and pathological significance of the level and extent of capsular invasion in clinical stage T1-2 prostate cancer. Hum Pathol. 1998;29(8):856–62.
32. Ming-Tse Sung, MD,*wz Haiqun Lin, MD, PhD, y Michael O. Koch, MD, J Darrell D. Davidson, MD, PhD,* and Liang Cheng M. Radial distance of extraprostatic extension measured by an ocular micrometer is an independent predictor of prostate-specific antigen recurrence: A new proposal for the substaging of pT3a prostate cancer [3]. Am J Surg Pathol. 2008;32(2):337–8.
33. Ng J, Mahmud A, Bass B, Brundage M. Prognostic significance of lymphovascular invasion in radical prostatectomy specimens. BJU Int. 2012;110(10):1507–14.
34. Ferrari MK, McNeal JE, Malhotra SM, Brooks JD. Vascular invasion predicts recurrence after radical prostatectomy: Stratification of risk based on pathologic variables. Urology. 2004;64(4):749–53.
35. Tan PH, Cheng L, Srigley JR, Griffiths D, Humphrey PA, Van Der Kwast TH, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. Working group 5: Surgical margins. Mod Pathol [Internet]. 2011;24(1):48–57. Available from: http://dx.doi.org/10.1038/modpathol.2010.155
36. Emerson RE, Koch MO, Daggy JK, Cheng L. Closest distance between tumor and resection margin in radical prostatectomy specimens: Lack of prognostic significance. Am J Surg Pathol. 2005;29(2):225–9.
37. Poulos CK, Koch MO, Eble JN, Daggy JK, Cheng L. Bladder neck invasion is an independent predictor of prostate-specific antigen recurrence. Cancer. 2004;101(7):1563–8.
38. Eastham JA, Kuroiwa K, Ohori M, Serio AM, Gorbonos A, Maru N, et al. Prognostic Significance of Location of Positive Margins in Radical Prostatectomy Specimens. Urology. 2007;70(5):965–9.
39. Babaian RJ, Troncoso P, Bhadkamkar VA, Johnston DA. Analysis of clinicopathologic factors predicting outcome after radical prostatectomy. Cancer. 2001;91(8):1414–22.
40. Dengfeng Cao, MD, PhD,* Adam S. Kibel, MD, w Feng Gao, MD, PhD, z Yu Tao, MD, z and Peter A. Humphrey, MD P. The gleason score of tumor at the margin in radical prostatectomy is predictive of biochemical recurrence. J Urol. 2011;185(2):516–7.
41. Kates M, Sopko NA, Han M, Partin AW, Epstein JI. Importance of Reporting the Gleason Score at the Positive Surgical Margin Site: Analysis of 4,082 Consecutive Radical Prostatectomy Cases. J Urol [Internet]. 2016;195(2):337–42. Available from: http://dx.doi.org/10.1016/j.juro.2015.08.002
42. Berney DM, Wheeler TM, Grignon DJ, Epstein JI, Griffiths DF, Humphrey PA, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 4: Seminal vesicles and lymph nodes. Mod Pathol [Internet]. 2011;24(1):39–47. Available from: http://dx.doi.org/10.1038/modpathol.2010.160
43. Potter SR, Epstein JI, Partin AW. Seminal vesicle invasion by prostate cancer: prognostic significance and therapeutic implications. Rev Urol [Internet]. 2000;2(3):190–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16985773%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC1476128
44. Ohori M, Scardino PT, Wheeler TM. The mecanisms and prognostic significance of seminal vesicle involvement by prostate cancer. Am J Surigcal Pathol. 1993;12(17):1252–61.
45. D’Amico A V., Whittington R, Bruce Malkowicz S, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. J Am Med Assoc. 1998;280(11):969–74.
46. Messing E. N+, M0 prostate cancer: Local therapy for systemic disease. Oncol (United States). 2013;27(7).
47. Abdollah F, Sun M, Thuret R, Jeldres C, Tian Z, Briganti A, et al. Lymph node count threshold for optimal pelvic lymph node staging in prostate cancer. Int J Urol. 2012;19(7):645–51.
48. Passoni NM, Fajkovic H, Xylinas E, Kluth L, Seitz C, Robinson BD, et al. Prognosis of patients with pelvic lymph node (LN) metastasis after radical prostatectomy: Value of extranodal extension and size of the largest LN metastasis. BJU Int. 2014;114(4):503–10.
49. Luchini C, Fleischmann A, Boormans JL, Fassan M, Nottegar A, Lucato P, et al. Extranodal extension of lymph node metastasis influences recurrence in prostate cancer: A systematic review and meta-Analysis. Sci Rep. 2017;7(1):1–7.
50. Egevad L, Srigley JR, Delahunt B. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens: Rationale and organization. Mod Pathol [Internet]. 2011;24(1):1–5. Available from: http://dx.doi.org/10.1038/modpathol.2010.159
2. Ministerio de la Protección Social. Guía de práctica clínica ( GPC ) para la detección temprana , seguimiento y rehabilitación del cáncer de próstata. 2013.
3. Samaratunga H, Montironi R, True L, Epstein JI, Griffiths DF, Humphrey PA, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 1: Specimen handling. Mod Pathol [Internet]. 2011;24(1):6–15. Available from: http://dx.doi.org/10.1038/modpathol.2010.178
4. Srigley JR, Humphrey PA, Amin MB, Chang SS, Egevad L, Epstein JI, et al. Protocol for the examination of specimens from patients with carcinoma of the prostate gland. Arch Pathol Lab Med. 2020;133(10):1568–76.
5. (ICCR) IC on CR. Prostate Cancer Histopathology Reporting Guide Radical Prostatectomy Specimen. 2017;(August):1–2.
6. Sewell C. Standards and Datasets for Reporting Cancers Dataset for histopathology reports for prostatic carcinoma. R Coll Pathol. 2016;(261035):1–31.
7. Dash A, Maine IP, Varambally S, Shen R, Chinnaiyan AM, Rubin MA. Changes in differential gene expression because of warm ischemia time of radical prostatectomy specimens. Am J Pathol. 2002;161(5):1743–8.
8. Best S, Sawers Y, Fu VX, Almassi N, Huang W, Jarrard DF. Integrity of Prostatic Tissue for Molecular Analysis After Robotic-Assisted Laparoscopic and Open Prostatectomy. Urology. 2007;70(2):328–32.
9. Egevad L. Handling of radical prostatectomy specimens. Histopathology. 2012;60(1):118–24.
10. Start RD, Layton CM, Cross SS, Smith JHF. Reassessment of the rate of fixative diffusion. J Clin Pathol. 1992;45(12):1120–1.
11. Harvey CJ, Pilcher J, Richenberg J, Patel U, Frauscher F. Applications of transrectal ultrasound in prostate cancer. Br J Radiol. 2012;85(SPEC. ISSUE 1):3–17.
12. Cohen MB, Soloway MS, Murphy WM. Sampling of radical prostatectomy specimens: How much is adequate? Am J Clin Pathol. 1994;101(3):250–2.
13. Duffield AS, Epstein JI. Detection of cancer in radical prostatectomy specimens with no residual carcinoma in the initial review of slides. Am J Surg Pathol. 2009;33(1):120–5.
14. Gleason D. Classification of prostatic carcinomas. Cancer Chemother reports. 1966;50(3):125–8.
15. Epstein JI, Amin MB, Reuter VE, Humphrey PA. Contemporary gleason grading of prostatic carcinoma. Am J Surg Pathol. 2017;41(4):e1–7.
16. Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. The 2014 international society of urological pathology (ISUP) consensus conference on gleason grading of prostatic carcinoma definition of grading patterns and proposal for a new grading system. Am J Surg Pathol. 2016;40(2):244–52.
17. Trock BJ, Guo CC, Gonzalgo ML, Magheli A, Loeb S, Epstein JI. Tertiary Gleason Patterns and Biochemical Recurrence After Prostatectomy: Proposal for a Modified Gleason Scoring System. 2015;182(4):1364–70.
18. Pierorazio PM, Walsh PC, Partin AW, Epstein JI. Prognostic Gleason grade grouping: Data based on the modified Gleason scoring system. BJU Int. 2013;111(5):753–60.
19. Chirag Doshi, Michael Vacchio, Kristopher Attwood, Christine Murekeyisoni, Diana C. Mehedint, Shervin Badkhshan1, Gissou Azabdaftari, Norbert Sule, Khurshid A. Guru, James L. Mohler and ECK. Clinical Significance of Prospectively Assigned Gleason Tertiary Pattern 4 in Contemporary Gleason Score 3+3 =6 Prostate Cancer. Prostate. 2017;76(8):715–21.
20. Epstein JI, Matoso A. Survival Guide to Prostate Pathology. 1st ed. Innovative Science Press; 2020. 145–177 p.
21. Sobin LH, Fleming ID. TNM classification of malignant tumors, Fifth edition (1997). Cancer. 1997;80(9):1803–4.
22. L.H. Sobin, M.K. Gospodarowicz CW. TNM Classification of Malignant Tumours. 2009. 368 p.
23. Van Der Kwast TH, Amin MB, Billis A, Epstein JI, Griffiths D, Humphrey PA, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 2: T2 substaging and prostate cancer volume. Mod Pathol [Internet]. 2011;24(1):16–25. Available from: http://dx.doi.org/10.1038/modpathol.2010.156
24. Paner GP, Stadler WM, Hansel DE, Montironi R, Lin DW, Amin MB. Updates in the Eighth Edition of the Tumor-Node-Metastasis Staging Classification for Urologic Cancers. Eur Urol [Internet]. 2018;73(4):560–9. Available from: http://dx.doi.org/10.1016/j.eururo.2017.12.018
25. Stamey TA, McNeal JE, Yemoto CM, Sigal BM, Johnstone IM. Biological determinants of cancer progression in men with prostate cancer. J Am Med Assoc. 1999;281(15):1395–400.
26. Sakai I, Harada KI, Kurahashi T, Yamanaka K, Hara I, Miyake H. Analysis of differences in clinicopathological features between prostate cancers located in the transition and peripheral zones. Int J Urol. 2006;13(4):368–72.
27. Sakai I, Harada KI, Hara I, Eto H, Miyake H. A comparison of the biological features between prostate cancers arising in the transition and peripheral zones. BJU Int. 2005;96(4):528–32.
28. Magi-Galluzzi C, Evans AJ, Delahunt B, Epstein JI, Griffiths DF, Van Der Kwast TH, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 3: Extraprostatic extension, lymphovascular invasion and locally advanced disease. Mod Pathol [Internet]. 2011;24(1):26–38. Available from: http://dx.doi.org/10.1038/modpathol.2010.158
29. Epstein JI, Carmichael M, Partin AW, Walsh PC. Is tumor volume an independent predictor of progression following radical prostatectomy? A multivariate analysis of 185 clinical stage B adenocarcinomas of the prostate with 5 years of followup. J Urol. 1993;149(6):1478–81.
30. Epstein JI. Pathologic assessment of the surgical specimen. Urol Clin North Am. 2001;28(3):567–94.
31. Wheeler TM, Dillioglugil Ö, Kattan MW, Arakawa A, Soh S, Suyama K, et al. Clinical and pathological significance of the level and extent of capsular invasion in clinical stage T1-2 prostate cancer. Hum Pathol. 1998;29(8):856–62.
32. Ming-Tse Sung, MD,*wz Haiqun Lin, MD, PhD, y Michael O. Koch, MD, J Darrell D. Davidson, MD, PhD,* and Liang Cheng M. Radial distance of extraprostatic extension measured by an ocular micrometer is an independent predictor of prostate-specific antigen recurrence: A new proposal for the substaging of pT3a prostate cancer [3]. Am J Surg Pathol. 2008;32(2):337–8.
33. Ng J, Mahmud A, Bass B, Brundage M. Prognostic significance of lymphovascular invasion in radical prostatectomy specimens. BJU Int. 2012;110(10):1507–14.
34. Ferrari MK, McNeal JE, Malhotra SM, Brooks JD. Vascular invasion predicts recurrence after radical prostatectomy: Stratification of risk based on pathologic variables. Urology. 2004;64(4):749–53.
35. Tan PH, Cheng L, Srigley JR, Griffiths D, Humphrey PA, Van Der Kwast TH, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. Working group 5: Surgical margins. Mod Pathol [Internet]. 2011;24(1):48–57. Available from: http://dx.doi.org/10.1038/modpathol.2010.155
36. Emerson RE, Koch MO, Daggy JK, Cheng L. Closest distance between tumor and resection margin in radical prostatectomy specimens: Lack of prognostic significance. Am J Surg Pathol. 2005;29(2):225–9.
37. Poulos CK, Koch MO, Eble JN, Daggy JK, Cheng L. Bladder neck invasion is an independent predictor of prostate-specific antigen recurrence. Cancer. 2004;101(7):1563–8.
38. Eastham JA, Kuroiwa K, Ohori M, Serio AM, Gorbonos A, Maru N, et al. Prognostic Significance of Location of Positive Margins in Radical Prostatectomy Specimens. Urology. 2007;70(5):965–9.
39. Babaian RJ, Troncoso P, Bhadkamkar VA, Johnston DA. Analysis of clinicopathologic factors predicting outcome after radical prostatectomy. Cancer. 2001;91(8):1414–22.
40. Dengfeng Cao, MD, PhD,* Adam S. Kibel, MD, w Feng Gao, MD, PhD, z Yu Tao, MD, z and Peter A. Humphrey, MD P. The gleason score of tumor at the margin in radical prostatectomy is predictive of biochemical recurrence. J Urol. 2011;185(2):516–7.
41. Kates M, Sopko NA, Han M, Partin AW, Epstein JI. Importance of Reporting the Gleason Score at the Positive Surgical Margin Site: Analysis of 4,082 Consecutive Radical Prostatectomy Cases. J Urol [Internet]. 2016;195(2):337–42. Available from: http://dx.doi.org/10.1016/j.juro.2015.08.002
42. Berney DM, Wheeler TM, Grignon DJ, Epstein JI, Griffiths DF, Humphrey PA, et al. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 4: Seminal vesicles and lymph nodes. Mod Pathol [Internet]. 2011;24(1):39–47. Available from: http://dx.doi.org/10.1038/modpathol.2010.160
43. Potter SR, Epstein JI, Partin AW. Seminal vesicle invasion by prostate cancer: prognostic significance and therapeutic implications. Rev Urol [Internet]. 2000;2(3):190–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16985773%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC1476128
44. Ohori M, Scardino PT, Wheeler TM. The mecanisms and prognostic significance of seminal vesicle involvement by prostate cancer. Am J Surigcal Pathol. 1993;12(17):1252–61.
45. D’Amico A V., Whittington R, Bruce Malkowicz S, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. J Am Med Assoc. 1998;280(11):969–74.
46. Messing E. N+, M0 prostate cancer: Local therapy for systemic disease. Oncol (United States). 2013;27(7).
47. Abdollah F, Sun M, Thuret R, Jeldres C, Tian Z, Briganti A, et al. Lymph node count threshold for optimal pelvic lymph node staging in prostate cancer. Int J Urol. 2012;19(7):645–51.
48. Passoni NM, Fajkovic H, Xylinas E, Kluth L, Seitz C, Robinson BD, et al. Prognosis of patients with pelvic lymph node (LN) metastasis after radical prostatectomy: Value of extranodal extension and size of the largest LN metastasis. BJU Int. 2014;114(4):503–10.
49. Luchini C, Fleischmann A, Boormans JL, Fassan M, Nottegar A, Lucato P, et al. Extranodal extension of lymph node metastasis influences recurrence in prostate cancer: A systematic review and meta-Analysis. Sci Rep. 2017;7(1):1–7.
50. Egevad L, Srigley JR, Delahunt B. International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens: Rationale and organization. Mod Pathol [Internet]. 2011;24(1):1–5. Available from: http://dx.doi.org/10.1038/modpathol.2010.159
Cómo citar
[1]
Camacho Nieto, D.F. et al. 2022. Preparación y manejo de especímenes en prostatectomía radical: revisión de la literatura y recomendaciones actuales. Revista Colombiana de Cancerología. 26, 3 (sep. 2022). DOI:https://doi.org/10.35509/01239015.813.
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