What pathologic findings after radical prostatectomy are predictive for occult metastases?
seminal vesicle invasion and lymph node metastases
positive surgical margins and seminal vesicle involvement
capsular penetration and lymph node metastases
rectal and bladder neck involvement
Correct Answer :
A. seminal vesicle invasion and lymph node metastases
the finding of seminal vesicle invasion and lymph node metastases are associated with a high risk of distant disease.
Related Questions
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
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 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
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 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
Clinically significant prostate cancer is defined as:
volume ≥ 0.5 mL and/or a Gleason score of ≥ 3 + 4
volume ≥ 0.8 mL and/or a Gleason score of ≥ 4 + 4
volume ≥ 1.5 mL and/or a Gleason score of ≥ 4 + 3
volume ≥ 1.0 mL and/or a Gleason score of ≥ 3 + 3
In which of the following PSA readings prostate cancer is least suspected?
PSA velocity of 0.35 ng/mL/y, when the PSA is ≤ 2.5 ng/mL
PSA velocity of 0.75 ng/mL/y, when the PSA is 4 10 ng/mL
t-PSA is 2.8 ng/mL, f-PSA 0.94 ng/mL
t-PSA is 3.7 ng/mL, f-PSA 0.51 ng/mL
Genetically, what are the changes associated with poor survival in prostate cancer patients?
loss of one or both copies of the tumor suppressor gene PTEN
TMPRSS2ERG chromosome fusion
P53 mutations and overexpression of MYC
all of the above
What is true about the usefulness of Gleason scoring system?
used to stage prostate cancer
a specimen of grade 3 + 4 is worse than 4 + 3
a sum of 6 suggests an intermediate risk for aggressive cancer
it has a role in guiding the appropriate treatment options
Following bilateral orchiectomy for prostate cancer, testosterone will:
initially drop to nadir, and then recover over 2 weeks
decline by 50% within 2 weeks and then normalize
decline by 90% within 24 hours
decline by 70%
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
What pathologic findings after radical prostatectomy are predictive for occult metastases?
seminal vesicle invasion and lymph node metastases
positive surgical margins and seminal vesicle involvement
capsular penetration and lymph node metastases
rectal and bladder neck involvement
What is false regarding the histology of prostatic cancers?
benign glands are different from malignant glands, as they contain basal cells
adenosis in the transitional zone carries 15% increase in cancer risk
the prostate has no discrete histologic capsule
intraductal carcinoma is morphologically worse than high-grade PIN and is typically associated with high-grade carcinoma
Fill the blanks: on treating prostate cancer patients, the median time from PSA failure to the development of metastatic disease after radical prostatectomy is approximately (…) yrs. and from the time of metastases to death is approximately (…) yrs..
4, 2 respectively
8, 5 respectively
6, 3 respectively
7, 4 respectively
Regarding radiotherapy for prostate cancer, what is the lowest recommended dose for salvage therapy?
54 Gy
64 Gy
74 Gy
84 Gy
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
What is the likelihood that prostate cells die in a single freeze cycle of cryotherapy when tissue temperature reaches colder than - 400 C?
never
unlikely
likely
always
Which PSA value interpretation is incorrect?
> 50% of men with PSA > 10 ng/mL have the disease beyond the prostate
pelvic lymph node involvement is found in PSA > 20 ng/mL
70% of men with a PSA between 4 and 10 ng/mL have organ-confined disease
80% of men with PSA < 4 ng/mL have organ-confined disease
What are the clinical parameters of tissue ablation achieved by cryotherapy for cancer cells destruction?
the number of freezing cycles
the lowest temperature achieved
the existence of regional heat sinks
all of the above
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
During retropubic radical prostatectomy, what complication could be encountered on dividing the dorsal vein complex anteriorly?
incontinence
retrograde ejaculation
impotence
anejaculation
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
In descending order, the commonest complications of external beam radiation therapy for prostate cancer are:
urethral stricture, impotence, and rectal bleeding
impotence, rectal bleeding, and urethral stricture
impotence, urethral stricture, and rectal bleeding
rectal bleeding, impotence, and urethral stricture
For prostate cancer patients, what do Partin tables predict?
survival rate
pathologic stage
extracapsular extension
lymph node involvement
Solid lesions in the seminal vesicles are most likely to be a result of:
imperfect prostate biopsies
immature teratoma
schistosomiasis
liposarcoma
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
Regarding treating prostate cancer patients, watchful waiting strategy involves:
periodic PSA testing
periodic TRUS
all of the above
none of the above
All of the following modalities are used as salvage therapies after failing radiation therapy for prostate cancer treatment, EXCEPT:
cryotherapy
chemotherapy
brachytherapy
radical prostatectomy
Which factor is closely related to the return to urinary continence function after radical retropubic prostatectomy?
pathologic tumor stage
performing nerve-sparing surgery
patient`s age
performing internal sphincter micro-dissection
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