Pathological Features After Radical Prostatectomy in Potential Candidates for Active Monitoring

Christopher R. Griffin, Xiaoying Yu, Stacy Loeb, Vic N. Desireddi, Misop Han, Theresa Graif, William J. Catalona*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Purpose: There are numerous reports on the results of watchful waiting or active monitoring protocols for men with low volume, biopsy Gleason grade 6 or less prostate cancer. When counseling patients with low grade prostate cancer about treatment options, it is useful to know the results of surgical treatment in this population. Materials and Methods: In a contemporary radical prostatectomy series there were 455 patients with biopsy Gleason grade 3 + 3 prostate cancer and information on the number of positive biopsy cores. Of these men 292 had low volume disease on the basis of 2 or fewer positive cores. Results: Overall 245 of 292 men (84%) with low volume Gleason 3 + 3 prostate cancer on biopsy had organ confined disease. The Gleason score in the prostatectomy specimen was 7 or greater in 78 men (27%), 25 (8%) had extracapsular tumor extension and 29 (10%) had positive surgical margins. In these patients preoperative variables were not reliable predictors of adverse pathological features. Conclusions: More than a third of Gleason 3 + 3 tumors on biopsy were upgraded in the radical prostatectomy specimen or had other adverse pathological features. Our results suggest that low volume Gleason 3 + 3 prostate cancer is frequently under staged, and that immediate therapy with radical prostatectomy is associated with favorable outcomes.

Original languageEnglish (US)
Pages (from-to)860-863
Number of pages4
JournalJournal of Urology
Volume178
Issue number3
DOIs
StatePublished - Sep 2007

Keywords

  • prostate-specific antigen
  • prostatectomy
  • prostatic neoplasms
  • risk assessment

ASJC Scopus subject areas

  • Urology

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