[Anatomopathologic reassessment of prostatic tumors exclusively affecting the organ with biologic progression and survival study of prostatectomized patients, in terms of the histologic characteristics of the tumor].
OBJECTIVE
The coexistence of tumours confined to the prostate and laboratory signs of progression is surprising unless we accept the possibility of errors of the pathological examination. In view of the high incidence of laboratory signs of progression after radical prostatectomy, it is important to define the most pejorative histological features in order to improve patient selection.


METHODS
129 radical prostatectomy specimens were studied, 8 out of 129 patients, with an immediate or secondary elevation of PSA while histological examination diagnosed a pT2 intracapsular cancer, were re-evaluated by reviewing the slides and resection of paraffin embedded blocks of prostate. The actuarial survival curves were analysed in 4 groups of patients, defined according to the various pathological characteristics of their tumour.


RESULTS
Review of the slides led to the diagnosis of 2 cases of focal capsular effraction and I case of seminal vesicle invasion. Resection of paraffin blocks led to the diagnosis of 2 cases of focal capsular effraction and one positive resection margin. The differences between the 4 survival curves with no laboratory signs of progression (PSA < 0.1 by highly sensitive polyclonal assay) were statistically significant except between patients whose tumour had extended beyond the capsule and those with positive resection margins.


CONCLUSIONS
Overall, resection of the blocks corrected the pathological staging in 2.3% of cases and global analysis of factors of poor prognosis can guide the urologist in this decision to administer adjuvant treatment.
Ravery
V
V
Service d'Urologie, Hôpital Bichat, Paris.
de la Taille
A
A
Toublanc
M
M
Boccon-Gibod
L
L
Delmas
V
V
Boccon-Gibod
L
L
D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D018450:Disease Progression; D005188:False Negative Reactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate
Réévaluation anatomopathologique des tumeurs prostatiques confinées à l'organe avec progression biologique et étude de survie des patients prostatectomisés en fonction des caractéristiques histologiques de leur tumeur.