Prostate

Question 1

Prostate staging: Tumor incidental histologic finding in 5% or less of tissue

Answer 1

T1a

Question 2

Prostate staging: Tumor incidental histologic finding in greater than 5% of tissue resected

Answer 2

T1b

Question 3

Prostate staging: Tumor identified by needle biopsy on one or both sides, but no palpable

Answer 3

T1c

Question 4

Prostate staging: pathologic - organ confined

Answer 4

pT2

Question 5

Prostate staging: palpable tumor involves one-half of one side or less

Answer 5

T2a

Question 6

Prostate staging: palpable tumor involves more than one-half of one side but not both

Answer 6

T2b

Question 7

Prostate staging: palpable tumor involves both sides

Answer 7

T2c

Question 8

Prostate staging: pathologic - EPE or microscopic invasion of bladder neck

Answer 8

pT3a

Question 9

Prostate staging: pathologic or clinical - tumor invades seminal vesicles

Answer 9

T3b

Question 10

Prostate staging: EPE that is not fixed and not invading other structures

Answer 10

T3a

Question 11

Prostate staging: pathologic or clinical - tumor is fixed or invades adjacent structures

Answer 11

T4

Question 12

Prostate staging: Metastasis in regional lymph nodes

Answer 12

N1

Question 13

Prostate staging: Metastasis in non-regional lymph nodes

Answer 13

M1a

Question 14

Prostate staging: Metastasis in bone

Answer 14

M1b

Question 15

Prostate staging: Metastasis in distant site w/w/o bone involvement

Answer 15

M1c

Question 16

Prostate: Dose constraints 70 Gy in 28 fx: Bowel bag max

Answer 16

< 54 Gy

Question 17

Prostate: Dose constraints 70 Gy in 28 fx: Bladder

Answer 17

V70 Gy < 35%

Question 18

Prostate: Dose constraints 70 Gy in 28 fx: penile bulb mean

Answer 18

< 51 Gy

Question 19

Prostate: Dose constraints 70 Gy in 28 fx: Rectum

Answer 19

V70 Gy < 25%

Question 20

Prostate: Dose constraints 70 Gy in 28 fx: Sigmoid Max

Answer 20

< 65 Gy

Question 21

Prostate NCCN risk stratification: Very low

Answer 21

Has all of the following:
cT1c
GG1
PSA <10
<3 cores positive, < 50% Ca in each
PSA density < 0.15 ng/mL/g

Question 22

Prostate NCCN risk stratification: Low

Answer 22

Has all of the following:
cT1-cT2a
GG1
PSA < 10

Question 23

Prostate NCCN risk stratification: Intermediate

Answer 23

Has all of the following:
No (very) high-risk features
1 or more IRF: cT2b-cT2c, GG2 or 3, PSA 10-20

Question 24

Prostate NCCN risk stratification: Favorable intermediate

Answer 24

Has all of the following:
1 IRF
GG1 or 2
< 50% of cores positive

Question 25

Prostate NCCN risk stratification: Unfavorable intermediate

Answer 25

Has one or more of the following: 2 or 3 IRFs GG3 > 50% cores positive

Question 26

Prostate NCCN risk stratification: High

Answer 26

Has one or more of the following but not very high risk cT3-cT4 GG4 or GG5 PSA 20-40 ng/mL

Question 27

Prostate NCCN risk stratification: Very high

Answer 27

Has at least two of the following cT3-cT4 GG4 or GG5 PSA > 40 ng/mL

Question 28

Prostate treatment recommendations by risk stratification

Answer 28

Low Risk: Surveillance Fav Int: Surveillance vs Tx Unfav Int: RT + short ADT High: RT + Long ADT Very High: RT + Long ADT + abi

Question 29

Prostate: Radiation dose for hypo-fractionated, SBRT and brachy

Answer 29

hypo: 70 Gy in 28 Fx SBRT: 36.25 Gy in 5 fx Brachy monotherapy (low, favorable and unfavorable): 13.5 x 2 implants Brachy boost (unfavorable, high, and very-high) EBRT 45 Gy in 25 fx then 10.75 in 2 fx

Question 30

Salvage after prostatectomy indication, dose, volume

Answer 30

PSA >0.2 ng/mL 6840 in 38 fx, nodes for PSA > 0.3, ADT for PSA > 0.5 1 cm below VUA, to Vas deferens, lateral to levator ani/obturator internus, anterior to pubic symphysis 2/3 then posterior 1 cm bladder, posterior to anterior rectal wall.