Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5183
Title: The impact of histopathological analysis of anterior peri-prostatic fat in radical prostatectomy patients
Authors: Joseph Filby
Alexander L Nesbitt 
Kapilan Ravichandran
Antoniou, Stefan 
Philip G Smith 
Garrath A Evans 
Benjamin Shepherd
Simon W Pridgeon 
Issue Date: 2020
Publisher: The British Association of Urological Surgeons
Source: Filby J, Nesbitt AL, Ravichandran K, et al. The impact of histopathological analysis of anterior peri-prostatic fat in radical prostatectomy patients. Journal of Clinical Urology. 2020;13(1):19-24. doi:10.1177/2051415819843434
Journal: Journal of Clinical Urology
Abstract: Objective: To determine the usefulness of histopathological analysis of peri-prostatic fat in a cohort of prostate cancer patients undergoing radical prostatectomy (RP) in an Australian regional centre. During RP, removal of the anterior peri-prostatic fat (APPF) is commonly undertaken; some surgeons routinely request histopathological analysis of this specimen. Previously published data show positive cancer detection in peri-prostatic fat in 0–2.5% of specimens and positive yields are mostly detected in patients with adverse pathological features. Subjects and methods: All patients undergoing RP in a regional urology unit in Queensland were identified. Pathology results were examined retrospectively to determine the rate of cancer involvement in APPF specimens and medical records were reviewed to assess any clinical impact. Results: APPF was sent for pathological analysis in 270/298 (90%) of patients undergoing RP. Prostate cancer was detected in one sample containing a single involved lymph node in a patient with Gleason 5 + 4 = 9 prostate cancer and pathological stage pT3bN1R1Mx. The presence of the cancer in the APPF did not affect the decision to offer adjuvant radiotherapy. Conclusion: In our population, we have identified a positive cancer yield of 0.3% in APPF specimens. When combined with all previously published series, we found positive cancer detection in 72/7391 (1%) specimens, and most patients with positive fat involvement had adverse pre-operative and final pathological features. Surgeons may consider omitting sending APPF specimens for analysis based on the low yield with little additional staging information. If surgeons continue this practice, they should consider selectively requesting analysis in intermediate- and high-risk patients. Level of evidence: 2b
Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Alexander L Nesbitt, Stefan Antoniou, Philip G Smith, Garrath A Evans, Simon W Pridgeon
DOI: 10.1177/2051415819843434
Keywords: radical prostatectomy;lymph node;prostate cancer;peri-prostatic fat;metastatic prostate cancer
Type: Article
Appears in Sites:Cairns & Hinterland HHS Publications

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