International society of urological pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. working group 4: Seminal vesicles and lymph nodes

Daniel M. Berney, Thomas M. Wheeler, David J. Grignon, Jonathan I. Epstein, David F. Griffiths, Peter A. Humphrey, Theo Van Der Kwast, Rodolfo Montironi, Brett Delahunt, Lars Egevad, John R. Srigley

Research output: Contribution to journalReview articlepeer-review

116 Scopus citations

Abstract

The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the infiltration of tumor into the seminal vesicles and regional lymph nodes were coordinated by working group 4. There was a consensus that complete blocking of the seminal vesicles was not necessary, although sampling of the junction of the seminal vesicles and prostate was mandatory. There was consensus that sampling of the vas deferens margins was not obligatory. There was also consensus that muscular wall invasion of the extraprostatic seminal vesicle only should be regarded as seminal vesicle invasion. Categorization into types of seminal vesicle spread was agreed by consensus to be not necessary. For examination of lymph nodes, there was consensus that special techniques such as frozen sectioning were of use only in high-risk cases. There was no consensus on the optimal sampling method for pelvic lymph node dissection specimens, although there was consensus that all lymph nodes should be completely blocked as a minimum. There was also a consensus that a count of the number of lymph nodes harvested should be attempted. In view of recent evidence, there was consensus that the diameter of the largest lymph node metastasis should be measured. These consensus decisions will hopefully clarify the difficult areas of pathological assessment in radical prostatectomy evaluation and improve the concordance of research series to allow more accurate assessment of patient prognosis.

Original languageEnglish (US)
Pages (from-to)39-47
Number of pages9
JournalModern Pathology
Volume24
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • lymph node
  • prostate adenocarcinoma
  • radical prostatectomy
  • seminal vesicle
  • tumor staging

ASJC Scopus subject areas

  • General Medicine

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