Finding of no tumor (pT0) in patients undergoing radical retropubic prostatectomy for clinically localized prostate cancer.
OBJECTIVE
To evaluate features and clinical outcome of patients with clinically localized prostate cancer graded pT0 following radical retropubic prostatectomy (RRP).


METHODS
Between 1974 and 2001 we performed 1,135 RRPs for cT1-T2 prostate cancer, of which 386 (34%) underwent 3-6 months of neoadjuvant endocrine treatment (NHT) before RRP. Median clinical follow-up was 53.8 months (range 24-251). Estimation of likelihood events for biochemical relapse was calculated according to the Kaplan-Meier method. Statistical differences between curves were calculated using the log-rank test.


RESULTS
In 24 cases (2.12%) routine histologic workup failed to detect residual tumor. The pT0 group contained a higher proportion of cTla-b patients and a biopsy Gleason score < or =6. A tendency toward lower pre-operatory PSA levels in the pT0 group compared to the pT2-3 group was shown. PSA progression was observed in 3 pT0 patients, all of whom previously underwent NHT.


CONCLUSIONS
Patients pT0 at RRP presented with lower preoperative PSA values and low preoperative Gleason score compared to the pT+ group. Absence of tumor at pathology examination has a different clinical meaning when it occurs following NHT or in untreated patients. Patients pT0 after NHT may have a worse clinical outcome than pT0 untreated patients.
Prayer-Galetti
Tommaso
T
Department of Urology, University of Padova, Padova, Italy. tommaso.prayer@unipd.it
Gardiman
Marina
M
Sacco
Emilio
E
Fracalanza
Simonetta
S
Betto
Giovanni
G
Pinto
Francesco
F
D000368:Aged; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
D006728:Hormones; D017430:Prostate-Specific Antigen