Editor's comment: undergrading and Understaging in Prostate Cancer

Abstract

etc., and as usual, the editor's comment highlights some papers.Doctor Oliveira and co-workers, from University of Sao Paulo, Brazil, evaluated on page 292 the undergrading and understaging rates in patients with clinically localized insignificant prostate cancer who underwent radical prostatectomy. Ninety-three patients fulfilled their criteria of nonsignificance: Gleason score < 7, stage T1c, PSA < 10 ng/mL and percentage of affected fragments less than 25%. The pathologic stage and Gleason score were compared to preoperative data to evaluate the rate of understaging and undergrading. The biochemical recurrence free survival of these operated insignificant cancers were also evaluated. They found on surgical specimen analysis that 74.7% of patients had Gleason score of 6 or less and 25.3% had Gleason 7 or greater. Furthermore, 8.3% of cases showed extracapsular extension. After 36 months of follow-up 3.4% had biochemical recurrence, defined by a PSA above 0.4 ng/mL. As conclusion, the authors have found considerable rates of undergrading and understaging in patients with prostate cancer whose current definitions classified them as candidates for active surveillance. Three of the most active urological pathologists in the world provided important editorial comment on this paper. Doctors Yang and Flaig, from University of Colorado Denver School of Medicine, Colorado, USA, presented on page 273 a nice review on novel targeted agents for the treatment of bladder novel targeted agents for the treatment of bladder cancer and discussed the translating laboratory advances into clinical application. The high frequency of recurrence of noninvasive bladder cancer and poor survival rate of invasive bladder cancer emphasizes the need for novel therapeutic approaches. The mechanisms of tumor development and promotion in bladder cancer are strongly associated with several growth factor pathways including the fibroblast, epidermal, and the vascular endothelial growth factor pathways. In this review, efforts to translate the growing body of basic science research of novel treatments into clinical applications were explored. Doctor Kariotis and co-workers, from "Asklipieion" General Hospital, Athens, Greece, determined on page 308 whether the peri-procedural administration of low-dose aspirin increases the risk of bleeding complications for patients undergoing extended prostate biopsies. They studied 530 men undergoing extended needle biopsies divided into two groups: those receiving aspirin and