Pathologic implications of prostatic anterior fat pad

Jeongyun Jeong, Eun Yong Choi, Dong I. Kang, Matt Ercolani, Dong Hyeon Lee, Wun Jae Kim, Isaac Yi Kim

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective: Lymph node status has significant pathologic implications in patients with prostate cancer. In this study, we have performed pathologic analysis of prostatic anterior fat pad (PAFP) excised during robot-assisted radical prostatectomy (RARP) to investigate the potential role of AFP on pathologic staging of prostate cancer. Methods: A total of 258 consecutive patients underwent PAFP excision during RARP between July 2007 and June 2009. PAFP was removed and submitted en bloc to the pathology department and evaluated for the presence of lymphoid tissue and metastatic prostate cancer. Retrospective chart review was performed for all patients. Results: Of the 258 patients, 30 (11.6%) had 1 or 2 PAFP lymph nodes and 228 (88.4%) men showed no lymphoid tissue in their PAFPs. Preoperatively, mean PSA level was higher in the former group. There were no significant pathologic differences between the 2 groups. Among the 30 patients with PAFP lymph nodes, 3 were positive for metastatic prostate cancer. All 3 of these patients had high-risk features preoperatively. In 1 patient, the pelvic lymph nodes were negative for metastatic prostate cancer. At 2-year follow up, PSA level of this patient was undetectable. Conclusions: Herein, we demonstrated that the PAFP contained lymph nodes in over 11% of the patients undergoing RARP at our institution. Prostate cancer was upstaged in 1 patient as a result of PAFP excision. Since this patient is free of biochemical recurrence at 2 years, routine excision and pathologic analysis of PAFP should be considered in prostate cancer patients undergoing radical prostatectomy.

Original languageEnglish
Pages (from-to)63-67
Number of pages5
JournalUrologic Oncology: Seminars and Original Investigations
Issue number1
StatePublished - Jan 2013

Bibliographical note

Funding Information:
This work was supported in part by generous grants from the Tanzman Foundation , the Jon Runyan's Score for the Cure , and Korea Science and Engineering Foundation (KOSEF) grant funded by the Korean government (MEST) (no. R11-2008-014-00001-0 ).


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