title: Validation of the contemporary epstein criteria for insignificant prostate cancer in European men.
abstract: OBJECTIVE
  The Epstein criteria represent the most widely used scheme for prediction of clinically insignificant prostate cancer (PCa). However, they were never validated in European men. We assessed the rate of unfavorable prostate cancer (Gleason 7-10 or non-organ-confined disease) in a cohort of 366 men who fulfilled the Epstein clinically insignificant PCa criteria.
  
  
  METHODS
  Between 1996 and 2006, 2580 men underwent radical prostatectomy at a single academic European institution. Of those, 366 fulfilled the contemporary Epstein clinically insignificant PCa criteria. Analyses targeted the rate of pathologically unfavorable prostate cancer, defined as either Gleason sum 7-10 or non-organ-confined disease, or a combination of these characteristics in patients with clinically insignificant PCa.
  
  
  RESULTS
  Gleason 7-10 prostate cancer at radical prostatectomy was found in 88 patients (24%) with clinically insignificant PCa. In addition, 30 (34.1%) of the 88 patients harboured non-organ-confined disease. Consequently, the contemporary Epstein criteria for clinically insignificant PCa were inaccurate in 24% of patients.
  
  
  CONCLUSIONS
  The Epstein clinical insignificant PCa criteria may underestimate the true nature of prostate cancer in as many as 24% of European patients. Therefore, caution is advised when treatment decisions are based solely on these criteria.
authors: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.
authors: Claudio
authors: C
authors: Jeldres
authors: Nazareno
authors: N
authors: Suardi
authors: Jochen
authors: J
authors: Walz
authors: Georg C
authors: GC
authors: Hutterer
authors: Sascha
authors: S
authors: Ahyai
authors: Jean-Baptiste
authors: JB
authors: Lattouf
authors: Alexander
authors: A
authors: Haese
authors: Markus
authors: M
authors: Graefen
authors: Andreas
authors: A
authors: Erbersdobler
authors: Hans
authors: H
authors: Heinzer
authors: Hartwig
authors: H
authors: Huland
authors: Pierre I
authors: PI
authors: Karakiewicz
mesh_terms: D000328:Adult; D000368:Aged; D005060:Europe; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology*