How does the finding of incidental proximal seminal vesicle invasion on mpMRI alter your recommendation for brachytherapy in a patient with prostate cancer who was initially a candidate?

An additional thought...........

Regarding this question as well we need to be cautious about the word "incidental". Normally an "incidental" finding would be characterized as a patient who was undergoing a CT scan of the abdomen and pelvis for the workup of a high grade prostate cancer, for instanc...

The MRI finding of proximal seminal vesicle invasion in a patient who is thought to have earlier stage disease based on clinical exam and other parameters is not that unusual of a clinical scenario. Often, such situations are observed among patients who have a larger volume of disease at the base wi...

Based on the recent ASCEDE-RT trial and many other retrospective studies, we combine EBRT and permanent seed implant for these patient. Using preloaded stranded seeds, especially the newer strands which tend NOT to migrate, does cover the target area.

In addition, based other prognostic features (PSA...

The comments above are 100% on the nose. Re-evaluation of the case as regards to other clinical factors is certainly warranted.

ASCENDE is the trial of note here with a roughly 50% relative reduction in PSA failure with addition of brachytherapy boost with 12 months of androgen deprivation and extern...