title: Stage pT0 after radical prostatectomy: a diagnostic dilemma.
abstract: BACKGROUND
  We assessed the misdiagnosed prostate cancer in radical prostatectomy (RP) specimens and the associated parameters.
  
  
  METHODS
  A total of 3,821 patients were treated by RP. A meticulous process to identify misdiagnosed PCa in the specimen was followed. This protocol included the review of biopsies, prostatic specimens after TURP and RP surgical specimens. The prostatic specimens were further sectioned. Immunohistochemistry was also performed. The clinical parameters of the cases that were confirmed to be pT0 stage were compared to 1,164 RP patients.
  
  
  RESULTS
  The incidence of pT0 was 0.7 % of the cases. Eighteen patients (Group A) were operated after TURP and 10 patients (Groups B) after transrectal ultrasound-guided biopsy of the prostate. Eleven (Group Ac) cases of Group A and seven (Group Bc) cases of Group B were confirmed to be pT0 cases. The re-examination of the slides and specimens revealed the presence of PCa in three cases. The remaining cases were detected by IHC. The comparison of Group Ac to the Group C (representative cohort, 1164 patients) showed that the pre-operative PSA value was significantly higher in the case of the Group C. The pre-operative Gleason, the percentage of biopsy cores for cancer and the length of cores containing cancer were observed to be significantly lower in the case of Group Bc in comparison with Group C.
  
  
  CONCLUSIONS
  The meticulous search protocol in pT0 cases showed that 35.7 % of the specimens included undiagnosed PCa. This strengthens the need for further careful work-up of any RP specimen of stage pT0.
authors.affiliation: Department of Urology, St. Elisabeth Krankenhaus, Leipzig, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Schirrmacher
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kallidonis
authors.forename: Lars-Christian
authors.initials: LC
authors.lastname: Horn
authors.forename: Hans
authors.initials: H
authors.lastname: Nenning
authors.forename: Jörg
authors.initials: J
authors.lastname: Rassler
authors.forename: Bhavan
authors.initials: B
authors.lastname: Rai
authors.forename: Minh
authors.initials: M
authors.lastname: Do
authors.forename: Evangelos
authors.initials: E
authors.lastname: Liatsikos
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Stolzenburg
mesh_terms: D000328:Adult; D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000453:epidemiology; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*