Extraprostatic extension (EPE) of prostatic carcinoma: is its proximity to the surgical margin or Gleason score important?
Data from this study using current International Society of Urological Pathology Gleason scoring and EPE criteria indicate that close proximity of EPE to the margin is not associated with recurrence. Gleason score ≥8 within EPE is associated with an increased BCR risk on univariable analysis, but larger studies are required to confirm whether extensive Gleason pattern 4 in an EPE indicates increased risk in an otherwise overall Gleason score 7 cancer.
Conservative management with drainage of ascites in combination with a radiological studies and optimal antibiotic treatment can prevent more invasive maneuvers such as exploratory laparotomy or laparoscopy.