ABSTRACT
The goals of treatment with primary radiotherapy are cancer cure with organ preservation. The treatment goals are achieved, in part, because cancer cells are generally more sensitive to the cytotoxic effects of ionizing radiation as compared to normal tissue. Nevertheless, normal tissue tolerance to radiotherapy may limit the radiation dose that may be delivered to a given anatomical site. Therefore, information regarding cancer location as it relates to normal adjacent tissue is relevant to the appropriate delivery of radiation therapy. Such information may be determined by analysis of pathologic data from primary surgical therapy. In cancer of the prostate, detailed histopathologic study of prostatectomy specimens and analysis of patient pretreatment prognostic factors has led to the development of various nomograms for predicting the presence of adverse pathologic features. Such nomograms may then be used to influence treatment approaches based on predicting the extent and location of cancer. In the radiotherapeutic management of prostate cancer, the key issues revolve around determining the risk of lymph node involvement (LNI), seminal vesicle involvement (SVI), and extraprostatic extension (EPE). The terminology, ‘extraprostatic extension’ (EPE), is preferred instead of ‘extracapsular extension’ (ECE), because the prostate does not have a complete capsule around it.1,2 As such, prostate cancer penetrating beyond the margin of the prostate at a location where a capsule is absent would not be appropriately termed ‘ECE’, a misnomer in such a circumstance, but rather EPE.
