title: Pathological features after radical prostatectomy in potential candidates for active monitoring.
abstract: OBJECTIVE
  There are numerous reports on the results of watchful waiting or active monitoring protocols for men with low volume, biopsy Gleason grade 6 or less prostate cancer. When counseling patients with low grade prostate cancer about treatment options, it is useful to know the results of surgical treatment in this population.
  
  
  METHODS
  In a contemporary radical prostatectomy series there were 455 patients with biopsy Gleason grade 3 + 3 prostate cancer and information on the number of positive biopsy cores. Of these men 292 had low volume disease on the basis of 2 or fewer positive cores.
  
  
  RESULTS
  Overall 245 of 292 men (84%) with low volume Gleason 3 + 3 prostate cancer on biopsy had organ confined disease. The Gleason score in the prostatectomy specimen was 7 or greater in 78 men (27%), 25 (8%) had extracapsular tumor extension and 29 (10%) had positive surgical margins. In these patients preoperative variables were not reliable predictors of adverse pathological features.
  
  
  CONCLUSIONS
  More than a third of Gleason 3 + 3 tumors on biopsy were upgraded in the radical prostatectomy specimen or had other adverse pathological features. Our results suggest that low volume Gleason 3 + 3 prostate cancer is frequently under staged, and that immediate therapy with radical prostatectomy is associated with favorable outcomes.
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Griffin
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Yu
authors.forename: Stacy
authors.initials: S
authors.lastname: Loeb
authors.forename: Vic N
authors.initials: VN
authors.lastname: Desireddi
authors.forename: Misop
authors.initials: M
authors.lastname: Han
authors.forename: Theresa
authors.initials: T
authors.lastname: Graif
authors.forename: William J
authors.initials: WJ
authors.lastname: Catalona
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*
chemical_list: D017430:Prostate-Specific Antigen