Regarding radical prostatectomy, the commonest site of positive surgical margins is the:
apex
posterior
postero-lateral
anterior
Correct Answer :
A. apex
the apex, followed by the posterior and the postero-lateral prostate.
Related Questions
Regarding radical prostatectomy, the commonest site of positive surgical margins is the:
apex
posterior
postero-lateral
anterior
In which of the following situations prostate biopsy is most indicated?
normal DRE, abnormal PSA
abnormal DRE, abnormal PSA
abnormal DRE, normal PSA
hyperechoic areas on TRUS
What is false concerning prostate cancer?
the most common cause of mortality in men with prostate cancer is cardiac disease
is the second most common cause of cancer death in males
androgens have a pivotal role in prostate cancer development
low protein and high carbohydrate diet play a role in the development of prostate cancer
Prostate-specific membrane antigen has been detected in:
the prostate gland only
the central nervous system, intestine, and the prostate
malignant ovarian cysts, skeletal muscles, and the prostate
thyroid glands, adrenals, and the prostate
What is false concerning antiandrogen class of prostate cancer medications?
commonly used in combination with a GnRH agonist
less effective than medical or surgical castration
not recommended for localized prostate cancer
inhibits various cytochrome P-450 enzymes
What is true surrounding PSA?
black individuals produce more PSA than whites
ejaculation can lead to a false decrease in PSA
pro-PSA is the serum proactive form of PSA molecule
prostate cancer cells make more PSA than normal prostate tissues do
Genetically, increased risk of prostate cancer has been found in men with:
variants in the 8q24 region on chromosome 8, in sporadic cases
alterations on chromosome 1, chromosome 17, and the X chromosome, in some familial cases
the human prostate cancer gene is on the X chromosome
all are true
During retropubic radical prostatectomy, what complication could be encountered on dividing the dorsal vein complex anteriorly?
incontinence
retrograde ejaculation
impotence
anejaculation
What is false concerning Gleason scoring system for prostate cancers?
ranges from 0 -10 based on a histologic evaluation of tumor specimens
based on the 2 most common histologic patterns
greatly relies on the skills and experience of the pathologist
a score of 7 indicates a moderate-grade or moderately differentiated tumor
What class of prostate cancer medications causes an initial increase in LH, FSH levels and consequently a rise in testosterone level for few weeks?
GnRH agonists
antiandrogens
antimicrotubular
bisphosphonates
What is false concerning TRUS prostatic biopsy?
a 12-core biopsy is the standard
in preparation for the procedure, a self-administered enema is suggested
sepsis might complicate the procedure
the biopsy path is best visualized in the coronal plane
Regarding treating prostate cancer patients, watchful waiting is a reasonable option for:
patients who have a life expectancy ≤ 10 yrs. and/or well to moderately differentiated cancer
≥ 70 yrs. of age
PSA < 10 ng/mL, ratio < 0.22
patients with good performance status
What is false concerning thawing procedure to treat prostate cancer cells?
slow thawing is more effective than rapid thawing
the most common complication is erectile dysfunction
for effective thawing a minimum temperature of − 25° C and a double freeze/thaw cycle with urethral warming are recommended
the two most common modalities employed in focal therapy are highintensity focused ultrasound and cryosurgery
Which of the following tests has the highest positive predictive value for prostate cancer?
PSA
digital rectal examination
transrectal ultrasonography
human kallikrein 2
Regarding treating prostate cancer patients, watchful waiting strategy involves:
periodic PSA testing
periodic TRUS
all of the above
none of the above
What is the major advantage of neoadjuvant androgen deprivation before radical prostatectomy on treating clinical stages (cT1-T2) prostate cancers?
reduces positive surgical margins
reduces local recurrence
has no proven advantage
reduces cardiac complications
What is false regarding the diagnosis of prostate cancer?
most cases are identified by screening asymptomatic men
physical examination alone cannot reliably differentiate benign prostatic conditions from cancer
most diagnosed cases have normal DRE and PSA values
prostate biopsy establishes the diagnosis
Regarding chemotherapy for prostate cancers, nonsteroidal antiandrogens will result in:
elevated LH, elevated testosterone, elevated estrogen
elevated LH, elevated testosterone, declined estrogen
declined LH, declined testosterone, elevated estrogen
declined LH, elevated testosterone, declined estrogen
What if false concerning the prostate cancer marker PCA3?
entails a genetic analysis of cells in the voided urine
urine sample is collected after a firm massage of the prostate
helps screen patients who are at intermediate risk of cancer
helps avoid the inconvenience of prostate biopsy
Concerning prostate cancers, a pre-treatment PSA velocity of > 2 ng/mL/yr is associated with an increased risk of:
pathological bone fractures
biochemical failure following radiation therapy
hepato-renal disease following chemotherapy
upgrading the pre-treatment risk stratification
What is against using TRUS-guided therapy for focal prostate cancer?
it overdiagnoses clinically insignificant cancers
it misses clinically significant cancers in the anterior or apical regions
it may underrepresent true cancer burden
all of the above
Which factor(s) determine(s) the return to normal erectile function after radical retropubic prostatectomy?
the age of the patient
preoperative potency status
extent of nerve-sparing surgery
all of the above
Regarding radiotherapy for prostate cancer, what is the lowest recommended dose for salvage therapy?
54 Gy
64 Gy
74 Gy
84 Gy
In which of the following cases PSA testing is NOT indicated:
72 yrs. man newly diagnosed BPH with normal DRE
2 weeks post TURP for obstructing cancerous prostate
screening for prostate cancer in 75 yrs. old Caucasian man
43 yrs. man with obstructive LUTS, who had a first-degree relative diagnosed with prostate cancer before age 65
Screening for prostate cancer is recommended for men who are:
at average risk, aging 50 yrs., and have at least a 10-year life expectancy
aging 40 yrs., and had a first-degree relative diagnosed with prostate cancer before age 65
aging 40 yrs., African Americans
all of the above
What is true concerning TRUS prostatic biopsy?
hematospermia might persist for 4 6 weeks after taking biopsies
quinolone antibiotics prophylaxis eliminate possible infections
the right lateral decubitus position is commonly preferred
only hypoechoic lesions should be biopsied
BPH patients on finasteride longer than 6 months are expected to have:
decreased t-PSA but increased f-PSA
decreased t-PSA but unaltered f-PSA
decreased t-PSA and decreased f-PSA
any of the above
What is the proper pre-treatment risk stratification of prostate cancer for a patient with T2a, PSA < 11 ng/mL, and no Gleason score > 6?
low risk
intermediate risk
high risk
data not adequate
What is the commonest complication of high-intensity focused ultrasound on treating localized prostate cancer?
temporary incontinence
vasculogenic impotence
urinary retention
hyper-reflexive detrusor
In descending order, to where do prostate cancers metastasize?
lymph nodes, bone, lung, bladder, liver, and adrenal glands
bone, lung, lymph nodes, liver, bladder, and adrenal glands
lung, liver, lymph nodes, bone, adrenal glands, and bladder
liver, lung, bone, lymph nodes, bladder, and adrenal glands