OBJECTIVE: To assess the frequency, circumstances, and possible medico-legal consequences of the pT0 prostate cancer, defined by the absence of tumor in a radical prostatectomy specimen.
METHODS: Six centers retrospectively identified all cases of pT0 and selectionned those that occurred without prior hormone therapy or prostate resection. Preoperative data, histological report and clinical and biological outcome were analyzed. The lawsuits' registry in pathology were consulted at insurance companies.
RESULTS: Thirty cases of pT0 prostate cancer (0.4%) were reported on 7693 patients. The median age was 63years, PSA 7.4ng/mL. The number of positive preoperative biopsies ranged from one to four for a median tumor length of 1mm (0.3 to 18mm). The biopsy Gleason score was 3+3 for 23 patients, less than 5 for six others and included a contingent of grade 4 in two patients. With a median follow-up of 82months, no clinical or biochemical recurrence was observed. One patient complaint for pT0 prostate was found in the insurances registry.
CONCLUSION: The occurrence of a prostate pT0 called into question all the diagnostic procedures and surgical indication. To avoid a forensic procedure, urologists should inform patients of the possibility of this situation before radical prostatectomy.
Written by:
Bessede T, Soulié M, Mottet N, Rebillard X, Peyromaure M, Ravery V, Salomon L; le sous-comité prostate du CC-AFU. Are you the author?
Service d'urologie, université Paris Sud, CHU de Bicêtre, 94270 Le Kremlin-Bicêtre, France.
Reference: Prog Urol. 2012 Dec;22(16):1021-5.
doi: 10.1016/j.purol.2012.07.018
PubMed Abstract
PMID: 23178099
Article in French.
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