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Stage pT0 after radical prostatectomy with previous positive biopsy sets: a multicenter study
Thomas Bessède1, Michel Soulié, Nicolas Mottet
1Centre Hospitalier Universitaire Henri Mondor, Créteil, France.
The Journal of Urology
|January 20, 2010
Summary
pT0 prostate cancer after biopsy-proven cancer is unpredictable but has an excellent prognosis. DNA analysis may be warranted due to medicolegal implications, though it doesn't alter patient outcomes.
Area of Science:
- Urology
- Pathology
- Oncology
Background:
- Radical prostatectomy is a common treatment for prostate cancer.
- pT0 tumors, defined as no cancer found in the prostatectomy specimen despite prior biopsy-proven cancer, present a unique diagnostic challenge.
Purpose of the Study:
- To analyze preoperative data, pathological findings, and follow-up outcomes for pT0 tumors after radical prostatectomy.
- To investigate the implications of pT0 findings in the context of biopsy-proven prostate cancer.
Main Methods:
- Retrospective analysis of 30 pT0 cases from 6 centers out of 7,693 radical prostatectomy specimens.
- Independent re-evaluation of biopsy cores and prostatectomy specimens by a second pathologist.
- Clinical and prostate-specific antigen (PSA) monitoring for a median of 82 months.
Main Results:
- Median patient age was 63 years with a median preoperative PSA of 7.4 ng/ml.
- Most cases were clinical stage T1c (24/30).
- No biochemical progression was observed during the median 82-month follow-up period.
Conclusions:
- pT0 prostate cancer following biopsy is an unpredictable finding with an excellent prognosis.
- Despite good outcomes, medicolegal considerations may necessitate DNA-based tissue analysis.
- Focal cancer detection post-resection does not appear to impact patient prognosis or treatment decisions.
