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
Correct Answer :
B. pelvic lymph node involvement is found in PSA > 20 ng/mL
pelvic lymph node involvement is found in nearly 20% of men with PSA > 20 ng/mL.
Related Questions
What is true regarding seminal vesicles` involvement in prostate cancer?
is almost always due to direct extension (T2c)
it is involved in 85% of positive surgical margins following radical prostatectomy
it carries a poor prognosis
none of the above
Ectopic expression of PSA occurs in all of the following, EXCEPT:
thyroid gland
breast tissue
adrenal glands
renal carcinomas
What is false concerning the interpretation of Gleason scoring system?
a low score means the cancer tissue is similar to normal prostate tissue
it indicates how likely the tumor will spread
the more cellular atypia observed the higher scoring will be
it relies only on the glandular architectural pattern
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 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
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 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
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
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
What is the likelihood that patients with positive surgical margins after radical prostatectomy will be cured for prostate cancer?
never
unlikely
likely
always
What are the possible complications of CO2 pneumoperitoneum during laparoscopic/robotic prostatectomy?
hypoxia and acidosis
tachycardia and tachypnea
bradycardia and hypotension
hypercarbia and oliguria
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
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
Regarding radiotherapy for prostate cancer, what is the lowest recommended dose for salvage therapy?
54 Gy
64 Gy
74 Gy
84 Gy
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
Which of the following tests has the highest positive predictive value for prostate cancer?
PSA
digital rectal examination
transrectal ultrasonography
human kallikrein 2
Partin tables are probability tables for the determination of pathologic stages of prostatic cancers based on:
preoperative clinical stage, PSA level, and Gleason sum
seminal vesicle invasion, lymph node metastases, and Gleason sum
positive surgical margins, capsular penetration, and PSA level
PSA level, perineural invasion, vascular metastasis, and Gleason sum
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
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
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 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
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
All of the following modalities are used as salvage therapies after failing radiation therapy for prostate cancer treatment, EXCEPT:
cryotherapy
chemotherapy
brachytherapy
radical prostatectomy
What is the first-line chemotherapeutic agent for metastatic castration-resistant prostate cancer?
bisphosphonate
docetaxel
sipuleucel-T
enzalutamide
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
What is true regarding prostatic tissue levels of hK2?
intensely expressed in benign prostatic epithelium
increased in poorly differentiated prostate cancer tissue
helps differentiate benign from malignant causes of high t-PSA
is an organ but not pathology specific marker
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
What advantage does laparoscopic/robotic prostatectomy has over open surgery in treating prostate cancers?
preserving potency
avoiding incontinence
less bleeding
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
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