Nondetectable Prostate Carcinoma (pT0) after Radical Prostatectomy: A Narrative Review

Abstract

(1) Background: Following radical prostatectomy (RP), the absence of a demonstrable tumor on the specimen of a previously histologically proven malignancy is known as the pT0 stage. The aim of our present study is to perform a narrative review of current literature in order to determine the frequency and oncological outcomes in patients with pT0 disease. (2) Methods: A narrative review of all available literature was performed. (3) Results: The incidence of pT0 ranges between 0.07% and 1.3%. Predictors of the pT0 stage are only a single biopsy core with low-grade cancer, a cancer length not exceeding 2 mm and a high prostate volume. Biochemical recurrence ranges between 0 and 11%. (4) Conclusions: The absence of malignancy in the RP specimen despite a previous positive biopsy is a rare and unpredictable finding. Although the prognosis is considered to be excellent in most of the cases, a continued close follow-up is warranted.

Gleason Grade Group 4 prostate biopsy with no cancer seen on final pathology in the magnetic resonance imaging and Prostate Specific Membrane Antigen‐Positron Emission Tomography era

“…The case of vanishing prostate cancer or pT0 among patients who have had prior histologically proven prostate cancer is reported at less than 2% 1 . For those individuals who have not received pre‐operative neoadjuvant hormonal therapy, the rates are reported to be lower than 1% 2 . Possible explanations described in the literature include errors in the pathological review of RP or biopsy specimens, mislabeling lab error, or biopsy removing all of the prostate cancer from the organ 2 …”

“…1 For those individuals who have not received pre-operative neoadjuvant hormonal therapy, the rates are reported to be lower than 1%. 2 Possible explanations described in the literature include errors in the pathological review of RP or biopsy specimens, mislabeling lab error, or biopsy removing all of the prostate cancer from the organ. 2 During preparation of the prostate specimen after a prostatectomy, slices of tissue are prepared for pathological review with a microtome.…”

“…2 Possible explanations described in the literature include errors in the pathological review of RP or biopsy specimens, mislabeling lab error, or biopsy removing all of the prostate cancer from the organ. 2 During preparation of the prostate specimen after a prostatectomy, slices of tissue are prepared for pathological review with a microtome. There is a small chance the focus of invasive carcinoma can be lost in this process; however, this explanation is difficult to conclude with any level of certainty in our case.…”

“… 2 Possible explanations described in the literature include errors in the pathological review of RP or biopsy specimens, mislabeling lab error, or biopsy removing all of the prostate cancer from the organ. 2 …”

Varnishing prostate cancer acinar (adenocarcinoma of the prostate gland pt0) in prostate biopsy specimen which subsequently becomes diagnosed as no prostate cancer or pt0 prostate cancer in a prostatectomy specimen: review and update

“…Bream et al [39] summarised the results as follows: • Of a total of 1,635 radical prostatectomies (RPs) undertaken, 4 (0.2%) not receiving neoadjuvant therapy or other prior prostate surgeries were stage pT0.…”