[Insignificant prostate cancer. Analysis our series]

Area of Science:

• Urology
• Oncology
• Pathology

Context:

• Active surveillance is a potential management strategy for prostate cancer.
• Accurate prediction of insignificant tumors is crucial for successful active surveillance.
• Radical prostatectomy (RP) specimens are analyzed to evaluate biopsy accuracy.

Purpose:

• To assess the correlation between biopsy findings and actual tumor insignificance in radical prostatectomy specimens.
• To determine the efficacy of diagnostic algorithms in identifying suitable candidates for active surveillance.
• To evaluate the characteristics of prostate cancers initially deemed low-risk based on biopsy.

Summary:

• The study analyzed 53 patients with low-risk prostate cancer (PSA ≤ 10, one positive core, Gleason score < 7) identified via biopsy.
• Only 41.5% of these patients had truly insignificant tumors (Gleason < 7, tumoral volume ≤ 5%) in their RP specimens.
• Despite discrepancies, 92.2% of the identified tumors in RP specimens were organ-confined.

Impact:

• Current diagnostic algorithms are insufficient for reliably predicting insignificant prostate cancer.
• Findings suggest limitations in using active surveillance for all patients with low-risk biopsy results.
• Further research is needed to improve diagnostic accuracy for active surveillance candidate selection.