Pathological T0 Prostate Cancer without Neoadjuvant Therapy: Clinical Presentation and Follow-Up

• Published in: European urology 2004, Vol.45 (1), p.36-41
• Main Authors: Herkommer, Kathleen, Kuefer, Rainer, Gschwend, Jürgen E, Hautmann, Richard E, Volkmer, Björn G
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Follow-up; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Male; Male genital diseases; Medical sciences; Middle Aged; Neoplasm Staging; Nephrology. Urinary tract diseases; Prognosis; Prostate cancer; Prostatectomy; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; pT0; Survival; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2003.08.001

Introduction and Objectives: Radical prostatectomy is a standard therapy for patients with prostate cancer diagnosed by prostatic needle biopsy, prostate cytology, transurethral resection of the prostate or prostatectomy. In a small group of patients no tumour can be found in the radical prostatectomy specimen. These cases are classified as stage pT0. The aim of this study was to evaluate the clinical presentation of this entity and their prognosis. Material and Methods: In a nation-wide database the clinical data of 3609 patients with prostate cancer were collected. 28 patients (0.8%) were staged as pT0 in the radical prostatectomy specimen. The data included age, prostate specific antigen (PSA), and pathological report at diagnosis, histology of the radical prostatectomy specimen and follow-up data. Results: The diagnosis was made by TURP (transurethral resection of the prostate) in 15, prostatectomy in 2, needle biopsy in 11, and cytology in 2 patients. For patients who underwent TURP or prostatectomy the preoperative staging was T1a in 10 and T1b in 5 cases. 12 patients diagnosed by biopsy or cytology were classified T2a and one patient after biopsy as T2b. 9 patients had a GI- and 19 a GII-tumour, GIII-pattern was not represented. The mean age at diagnosis was 64.7 years (range 53–79 years). The PSA at the time of diagnosis was 10 ng/ml in 4 patients. One patient presented with a micrometastasis in a single lymph node. Median follow-up was 62 months (19–150). All patients had undetectable PSA levels following surgery. No patient presented with clinical or biochemical progression. One patient died with no evidence of disease at 133 months after radical prostatectomy. Conclusions: None of the clinical parameters had a strong association with a pathologically proven T0 situation after radical prostatectomy in this setting. Interestingly no patient had a high-grade tumour. None of the patients classified as pT0 had a biochemical or clinical relapse during follow-up.