Redefining the Concept of Clinically Insignificant Prostate Cancer

To assess the risk of biochemical recurrence (BCR) in small low-grade prostate tumors following radical prostatectomy (RP), which are defined as clinically insignificant based on the existing criteria developed by Stamey and Epstein. We identified 3784 men who underwent RP in Western Australia from...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2020-02, Vol.136, p.176-179
Main Authors: Frankcombe, Daisy E., Li, Jian, Cohen, Ronald J.
Format: Article
Language:English
Subjects:
Humans
Male
Middle Aged
Neoplasm Grading
Neoplasm Recurrence, Local - epidemiology
Prostatectomy
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Risk Assessment
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Summary:To assess the risk of biochemical recurrence (BCR) in small low-grade prostate tumors following radical prostatectomy (RP), which are defined as clinically insignificant based on the existing criteria developed by Stamey and Epstein. We identified 3784 men who underwent RP in Western Australia from September 1998 to March 2019. These patients had a Gleason sum (GS) of ≤6 or 3+4, prostate confined and negative margins. Pathological data analysis was performed using logistic regression modeling. Median follow-up was 96.8 months. BCR occurred in 110 men (2.91%). There was no statistical difference in the rates of failure for patients with a tumor volume 2 mL when the percentage of Gleason pattern 4 was ≤20%. However, once the percentage of Gleason pattern 4 increased to 30%, there was a significant increase in BCR in the larger tumors (> 2 mL). This study did not support either Stamey's or Epstein's criteria of insignificant cancer based on volumes of less than 0.5 mL, GS
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2019.10.019