Application of the Epstein criteria for prediction of clinically insignificant prostate cancer in Korean men.
OBJECTIVE
To investigate the rate of pathologically confirmed unfavourable prostate cancers among Korean men who fulfilled the contemporary Epstein criteria for clinically insignificant prostate cancer.


METHODS
This was a retrospective study of 131 Korean men who underwent radical prostatectomy (RP) for clinically insignificant prostate cancer as defined by contemporary Epstein criteria. We assessed the percentage of unfavourable prostate cancer (pathological Gleason sum > or = 7 and/or extraprostatic extension [EPE]) among these men and tried to identify useful predictors for such unfavourable tumour profiles using uni- and multivariate analyses.


RESULTS
Among 131 men with clinically insignificant prostate cancer, 40 (30.5%) had pathological Gleason > or = 7 tumours after RP. Of these 40 men, four (3.1%) also had EPE on examination of RP specimen. All those who did not have Gleason score upgrading after RP had organ-confined disease from examination of RP specimen. Overall, 40 (30.5%) of the 131 men who fulfilled the contemporary Epstein criteria for clinically insignificant prostate cancer before RP had pathologically unfavourable disease. Among our patients, no significant preoperative predictor of pathologically unfavourable disease was identified using uni- and multivariate analyses.


CONCLUSIONS
Our results showed that a significant proportion of contemporary Korean patients who meet all the conditions of the contemporary Epstein criteria for prediction of clinically insignificant prostate cancer might actually harbour prostate cancer with unfavourable pathological features. Such findings should be considered when treatment options are contemplated based upon the Epstein criteria among Asian patients.
Lee
Sang E
SE
Department of Urology, Seoul National Bundang Hospital, Seongnam, Korea.
Kim
Dae S
DS
Lee
Won K
WK
Park
Hong Z
HZ
Lee
Chang J
CJ
Doo
Seung H
SH
Jeong
Seong J
SJ
Yoon
Cheol Y
CY
Byun
Seok-Soo
SS
Choe
Gheeyoung
G
Hwang
Sung I
SI
Lee
Hak J
HJ
Hong
Sung K
SK
D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards; D006801:Humans; D007723:Korea / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies