What's new in prostate cancer disease assessment in 2006?
OBJECTIVE
Issues relating to the disease are critical in the diagnosis, management, and prognostication of prostate cancer.


RESULTS
New data have emerged regarding the disease of prostate cancer and its precursors. The diagnosis of prostate cancer on needle biopsy has been refined because of the recent discovery of alpha-methylacyl-CoA racemase, which preferentially labels adenocarcinoma of the prostate. Modifications and additions to the Gleason grading system were published based on a consensus conference of urological pathologists. Various models have been proposed using Gleason score, clinical findings, as well as measurements of tumor volume on needle biopsy to enhance the prediction in men undergoing radical prostatectomy and to predict "insignificance". Several studies have confirmed that certain findings in radical prostatectomy are adverse, yet conflicting studies were published as to the independent prognosis of tumor volume. The risk of cancer following a diagnosis of high-grade prostatic intraepithelial neoplasia on needle biopsy has decreased to the point at which this author does not recommend a routine repeat needle biopsy within the first year following the diagnosis of high-grade prostatic intraepithelial neoplasia.


CONCLUSIONS
This review summarizes developments over the last year in the disease of prostate cancer and its precursors.
Epstein
Jonathan I
JI
Departments of Disease, Urology, and Oncology, The Johns Hopkins Hospital, 401 N. Broadway, Baltimore, MD 21231, USA. jepstein@jhmi.edu