title: Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?
abstract: OBJECTIVE
  The aim of active surveillance of early prostate cancer is to individualize therapy by selecting for curative treatment only patients with significant cancer. Epstein's criteria for prediction of clinically insignificant cancer in surgical specimens are widely used. Epstein's criterion "no single core with >50% cancer has no correspondence in linear extent. The aim of this study is to find a possible correspondence.
  
  
  METHODS
  From a total of 401 consecutive patients submitted to radical prostatectomy, 17 (4.2%) met criteria for insignificant cancer in the surgical specimen. The clinicopathologic findings in the correspondent biopsies were compared with Epstein's criteria for insignificant cancer. Cancer in a single core was evaluated in percentage as well as linear extent in mm.
  
  
  RESULTS
  Comparing the clinicopathologic findings with Epstein's criteria predictive of insignificant cancer, there was 100% concordance for clinical stage T1c, no Gleason pattern 4 or 5, ≤ 2 cores with cancer, and no single core with >50% cancer. However, only 25% had density ≤ 0.15. The mean, median and range of the maximum length of cancer in a single core in mm were 1.19, 1, and 0.5-2.5, respectively. Additionally, the mean, median, and range of length of cancer in all cores in mm were 1.47, 1.5, and 0.5-3, respectively.
  
  
  CONCLUSIONS
  To pathologists that use Epstein's criteria predictive of insignificant cancer and measure linear extent in mm, our study favors that "no single core with >50% cancer" may correspond to >2.5 mm in linear extent.
authors.affiliation: Department of Anatomic Pathology, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.
authors.forename: Athanase
authors.initials: A
authors.lastname: Billis
authors.affiliation: Department of Anatomic Pathology, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.
authors.forename: Maisa M Q
authors.initials: MM
authors.lastname: Quintal
authors.affiliation: Department of Anatomic Pathology, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.
authors.forename: Leandro L L
authors.initials: LL
authors.lastname: Freitas
authors.affiliation: Department of Anatomic Pathology, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.
authors.forename: Larissa B E
authors.initials: LB
authors.lastname: Costa
authors.affiliation: Department of Urology (UF), School of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.
authors.forename: Ubirajara
authors.initials: U
authors.lastname: Ferreira
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D015588:Observer Variation; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D047368:Tumor Burden
chemical_list: D017430:Prostate-Specific Antigen