title: Prediction of pathological outcomes for a single microfocal (≤3 mm) Gleason 6 prostate cancer detected via contemporary multicore (≥12) biopsy in men with prostate-specific antigen ≤10 ng/mL.
abstract: OBJECTIVE
  • To examine potential predictors of pathological outcomes for a single microfocal (≤3 mm) positive prostate cancer detected via contemporary biopsy scheme in patients presenting with prostate-specific antigen (PSA) ≤10 ng/mL.
  
  
  METHODS
  • We reviewed the data of 119 patients who had prebiopsy PSA ≤ 10 ng/mL and a single microfocal (≤3 mm) Gleason ≤6 prostate cancer identified via multicore (≥12) biopsy and who subsequently underwent radical prostatectomy (RP). • We assessed the rates of insignificant prostate cancer (organ-confined and pathological Gleason ≤6 with tumour volume <0.5 mL) and unfavourable prostate cancer (upstaging and/or upgrading) by analysing pathological findings. • Potential preoperative predictors of insignificant or unfavourable prostate cancer were analysed. Multivariable models for predicting insignificant and unfavourable tumours were devised and evaluated.
  
  
  RESULTS
  • Overall rates of insignificant and unfavourable prostate cancer were 44.5% and 24.4%, respectively. In multivariate analysis, only PSA density was an independent predictor of insignificant prostate cancer. • Predictive accuracies of multivariable models for predicting insignificant prostate cancer did not exceed 68.2%. No significant predictor for pathologically unfavourable tumour was found in multivariate analysis. • All versions of the multivariable model devised for prediction of unfavourable tumour showed predictive accuracies ≤66.9%.
  
  
  CONCLUSIONS
  • Although PSA density can be considered an independent predictor of pathologically insignificant tumour among patients with PSA ≤10 ng/mL and only a single microfocal tumour detected via multicore (≥12) biopsy, the clinical and biopsy-related parameters that are currently available have limited value in predicting pathologically insignificant or unfavourable prostate cancer in such patients.
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
authors.forename: Woong
authors.initials: W
authors.lastname: Na
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Park
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Oh
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Nam
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Jeong
authors.forename: Gheeyoung
authors.initials: G
authors.lastname: Choe
authors.forename: Hak Jong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Hwang
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen