Pathological features after radical prostatectomy in potential candidates for active monitoring.
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.
Griffin
Christopher R
CR
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Yu
Xiaoying
X
Loeb
Stacy
S
Desireddi
Vic N
VN
Han
Misop
M
Graif
Theresa
T
Catalona
William J
WJ
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*
D017430:Prostate-Specific Antigen