title: Radical Prostatectomy Findings in White Hispanic/Latino Men With NCCN Very Low-risk Prostate Cancer Detected by Template Biopsy.
abstract: Radical prostatectomy (RP) outcomes have been studied in White and Black non-Hispanic men qualifying for Epstein active surveillance criteria (EASC). Herein, we first analyzed such outcomes in White Hispanic men. We studied 70 men with nonpalpable Gleason score 3+3=6 (Grade Group [GG] 1) prostate cancer (PCa) with ≤2 positive cores on biopsy who underwent RP. In 18 men, prostate-specific antigen (PSA) density (PSAD) was >0.15 ng/mL/g. Three of these had insignificant and 15 had significant PCa. The remaining 52 men qualified for EASC. One patient had no PCa identified at RP. Nineteen (37%) had significant PCa defined by volume (n=7), grade (n=7), and volume and grade (n=5). Nine cases were 3+4=7 (GG 2) (5/9 [56%] with pattern 4 <5%), 2 were 3+5=8 (GG 4), and 1 was 4+5=9 (GG 5). Patients with significant PCa more commonly had anterior dominant disease (11/19, 58%) versus patients with insignificant cancer (7/33, 21%) (P=0.01). In 12 cases with higher grade at RP, the dominant tumor nodule was anterior in 6 (50%) and posterior in 6 (median volumes: 1.1 vs. 0.17 cm, respectively; P=0.01). PSA correlated poorly with tumor volume (r=0.28, P=0.049). Gland weight significantly correlated with PSA (r=0.54, P<0.001). While PSAD and PSA mass density correlated with tumor volume, only PSA mass density distinguished cases with significant disease (median, 0.008 vs. 0.012 μg/g; P=0.03). In summary, a PSAD threshold of 0.15 works well in predicting significant tumor volume in Hispanic men. EASC appear to perform better in White Hispanic men than previously reported outcomes for Black non-Hispanic and worse than in White non-Hispanic men. Significant disease is often Gleason score 3+3=6 (GG 1) PCa >0.5 cm. Significant PCa is either a larger-volume anterior disease that may be detected by multiparametric magnetic resonance imaging-targeted biopsy or anterior sampling of the prostate or higher-grade smaller-volume posterior disease that in most cases should not pose immediate harm and may be detected by repeat template biopsies.
authors.affiliation: Departments of *Pathology and Laboratory Medicine †Urology §Radiation Oncology ‡Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Oleksandr N
authors.initials: ON
authors.lastname: Kryvenko
authors.forename: Kirill
authors.initials: K
authors.lastname: Lyapichev
authors.forename: Felix M
authors.initials: FM
authors.lastname: Chinea
authors.forename: Nachiketh Soodana
authors.initials: NS
authors.lastname: Prakash
authors.forename: Alan
authors.initials: A
authors.lastname: Pollack
authors.forename: Mark L
authors.initials: ML
authors.lastname: Gonzalgo
authors.forename: Sanoj
authors.initials: S
authors.lastname: Punnen
authors.forename: Merce
authors.initials: M
authors.lastname: Jorda
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology* / Q000473:pathology*; D001706:Biopsy; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000473:pathology*; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen