OBJECTIVE: To find out which factors could predict the diagnosis of insignificant prostate cancer (ins-PCa) according to a recently updated definition (overall tumor volume up to 2.5 cm3; final Gleason score ≤ 6; organ-confined disease) on a prostatic biopsy specimen.
METHODS: This was a retrospective analysis of 210 patients undergoing radical prostatectomy for a cT1c prostate neoplasm with a biopsy specimen Gleason score of ≤ 6. A logistic regression model was used to assess the differences in the distribution of some possibly predictive factors between the ins-PCa patients, according to the updated definition, and the remaining patients.
RESULTS: By applying an updated definition of ins-PCa, the prevalence of this condition increased from 13.3% to 49.5% (104 of 210 patients). The univariate analysis showed a statistically different distribution of the following factors: prostate-specific antigen density, prostate volume, number of cancer-involved cores, and maximum percentage of core involvement by cancer. At the multivariable analysis, the maximum percentage of involvement of the core retained its relevance (27.0% in ins-PCa patients and 43.8% in the remaining patients; hazard ratio, 0.972; P = .046), and a 20% cutoff was detected.
CONCLUSION: In a cohort of patients with PCa cT1c and a biopsy specimen Gleason score of ≤ 6, the ins-PCa rate, according to the updated definition, is close to 50%, and the percentage of cancer involvement of the core is the single factor that best predicts this diagnosis.
Written by:
Antonelli A, Vismara Fugini A, Tardanico R, Giovanessi L, Zambolin T, Simeone C. Are you the author?
Department of Urology, Spedali Civili Hospital and University of Brescia, Brescia, Italy.
Reference: Urology. 2013 Oct 23. pii: S0090-4295(13)01082-0.
doi: 10.1016/j.urology.2013.07.056
PubMed Abstract
PMID: 24269219
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