title: The accuracy of pathological data for the prediction of insignificant prostate cancer.
abstract: BACKGROUND
  The widespread screening programs prompted a decrease in prostate cancer stage at diagnosis, and active surveillance is an option for patients who may harbor clinically insignificant prostate cancer (IPC). Pathologists include the possibility of an IPC in their reports based on the Gleason score and tumor volume. This study determined the accuracy of pathological data in the identification of IPC in radical prostatectomy (RP) specimens.
  
  
  METHODS
  Of 592 radical prostatectomy specimens examined in our laboratory from 2001 to 2010, 20 patients harbored IPC and exhibited biopsy findings suggestive of IPC. These biopsy features served as the criteria to define patients with potentially insignificant tumor in this population. The results of the prostate biopsies and surgical specimens of the 592 patients were compared.
  
  
  RESULTS
  The twenty patients who had IPC in both biopsy and RP were considered real positive cases. All patients were divided into groups based on their diagnoses following RP: true positives (n = 20), false positives (n = 149), true negatives (n = 421), false negatives (n = 2). The accuracy of the pathological data alone for the prediction of IPC was 91.4%, the sensitivity was 91% and the specificity was 74%.
  
  
  CONCLUSIONS
  The identification of IPC using pathological data exclusively is accurate, and pathologists should suggest this in their reports to aid surgeons, urologists and radiotherapists to decide the best treatment for their patients.
authors.affiliation: Laboratory of Medical Research, Department of Urology, University of São Paulo Medical School and Laboratory of Surgical and Molecular Pathology - Sirio Libanes Hospital, São Paulo, Brazil.
authors.forename: Betina
authors.initials: B
authors.lastname: Katz
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
authors.forename: Luiz H
authors.initials: LH
authors.lastname: Camara-Lopes
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Antunes
authors.forename: Luciano
authors.initials: L
authors.lastname: Nesrallah
authors.forename: Adriano
authors.initials: A
authors.lastname: Nesrallah
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Dall'Oglio
authors.forename: Katia R M
authors.initials: KR
authors.lastname: Leite
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D015203:Reproducibility of Results; D047368:Tumor Burden