[Nondetectable prostate cancer in radical prostatectomy specimens]

Area of Science:

• Urology
• Oncology
• Pathology

Context:

• Increased use of prostate-specific antigen (PSA) has led to earlier prostate cancer diagnosis.
• A higher frequency of low-volume disease or no tumor is detected in radical prostatectomy specimens.

Purpose:

• To analyze patients staged as pT0 after radical prostatectomy.
• To investigate the influence of neoadjuvant hormonal therapy on pT0 staging rates.

Summary:

• Retrospective analysis of 1134 radical prostatectomies (1996-2010) identified 32 (2.8%) pT0 cases.
• pT0 staging rate was significantly higher in the neoadjuvant hormonal therapy group (9.3%) compared to the non-hormonally treated group (1.2%).
• Biochemical relapse occurred in 3 pT0 patients receiving hormonal therapy, suggesting these may not be true pT0 cases.

Impact:

• Neoadjuvant hormonal therapy appears to increase the rate of pT0 staging, but these cases may not represent true absence of cancer.
• True pT0 staging in non-hormonally treated patients is approximately 1%, with an excellent prognosis.
• Findings emphasize careful evaluation of pT0 cases, especially in patients receiving neoadjuvant hormonal therapy.