How is the extension of prostate adenocarcinoma?

Extends to periprostatic fat by capsular penetration, then to seminal vesicles by continguity (direct extension along ejaculatory ducts or from neighboring fat) Very rare rectal involvment in large tumors only, bladder neck/trigone/ureters involvement in locally evolved tumors. Ganglionic extension is pelvic first then retroperitoneal lumbar-aortic, or supra-diaphragmatic. Most frequent metastasis are ganglionic and bony, osteblastic lesions predominate in axial skeleton