Pathologic Findings in Radical Prostatectomy Specimens From Patients Eligible for Active Surveillance With Highly Selective Criteria: A Multicenter Study

Beauval, Jean-Baptiste; Ploussard, Guillaume; Soulié, M.; Pfister, Christian; Agt, S. Van; Vincendeau, S.; Larue, Sébastien; Rigaud, J.; Gaschignard, N.; Rouprêt, Morgan; Drouin, S.; Peyromaure, M.; Long, Jean-Alexandre; Iborra, François; Vallancien, Guy; Rozet, François; Salomon, Laurent

doi:10.1016/j.urology.2012.04.051

Cited by 63 publications

(51 citation statements)

References 25 publications

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“…The presence of PSMs is considered a poor prognostic factor in patients after RRP, but the impact on clinical end points is a topic of ongoing discussion (29). Mauermann found that 34.5% of patients with pT2-T4 had PSMs (29).…”

Section: Discussionmentioning

confidence: 99%

Can Single Positive Core Prostate Cancer at biopsy be Considered a Low-Risk Disease after Radical Prostatectomy?

et al. 2013

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Purpose: Single positive core in a prostate biopsy is usually associated with indolent prostate cancer (PCa) and is one of the active surveillance (AS) inclusion criteria. We investigated whether single positive core PCa at biopsy could define an archetype of low-risk disease. Materials and Methods: A total of 1320 consecutive patients were enrolled. Among them, 249 patients with single positive core PCa were followed up, and the clinical and pathological parameters influencing prognosis were analyzed. Results: Out of the 249 patients, 172 (69.0%) had pathological findings ≥ pT2c and 87 (34.9%) had an undergraded Gleason Score (GS) based on the biopsy. Positive surgical margins (PSMs), extraprostatic extension (EPE) and seminal vesicle invasion (SVI) were found in 20.8%, 10.0% and 6.0% of patients, respectively. In a comparative analysis, we found that the PSA level, prostate weight and number of cores at biopsy are essential to correctly predict an indolent PCa. A total of 125 patients (67.3%) with nonpalpable tumors became high-risk tumors (pT2c-T3). Analyzing only nonpalpable tumors with a GS of 6 at biopsy (156 patients), we noted that 106 (67.9% of cT1) progressed from cT1c to pT2c-pT3. Conclusions: Single core PCa have clinically significant disease in the Radical Prostatectomy specimens, with considerable rates of overgrading for the GS, pT2c-pT3, PSMs, EPE and SVI. The treatment plan must be evaluated individually for patients with single core PCa and must take into account other prognostic factors when determining whether a patient should be managed with AS. Can

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Section: Discussionmentioning

confidence: 99%

Can Single Positive Core Prostate Cancer at biopsy be Considered a Low-Risk Disease after Radical Prostatectomy?

et al. 2013

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“…[5][6][7] These men were often treated with radical prostatectomy (RP) or radiotherapy prior to widespread AS adoption and, if treated immediately, men with these disease features typically displayed excellent response to RP with 5-year biochemical recurrence-free survival rates ranging from 81% to 92%. 8,9 If AS protocols are followed correctly and the trigger for active treatment is clinical progression out of the very-low-risk category and founded on an oncologic basis rather than patient anxiety, the disease characteristics of the cohort of men being treated with RP would theoretically worsen. Indeed recent reports suggest a reverse stage migration of men presenting for RP in the era of AS, with a significant decrease in the percentage of low-risk patients.…”

Section: Introductionmentioning

confidence: 99%

Oncologic outcomes following radical prostatectomy in the active surveillance era

Louis

Kalnin²,

Maganti

et al. 2013

CUAJ

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ORIGINAL RESEARCH E475Cite as: Can Urol Assoc J 2013;7(7-8):e475-80. http://dx.doi.org/10.5489/cuaj.1404 Published online July 2, 2013. AbstractObjective: In this study, we examine the oncologic outcomes of men with low, intermediate and high preoperative risk for prostate cancer treated with radical prostatectomy prior to and during the active surveillance era. Methods: We analyzed records from patients who underwent radical prostatectomy at our Canadian tertiary care facility from 2000 to 2012. Patients were stratified by D'Amico preoperative risk category and by year of treatment. Biochemical recurrence-free survival was estimated using the Kaplan-Meier method.

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“…Beauval et al [19] with 919 cases that met strict criteria for AS found that the Gleason score was reclassified in 34% of the cases and 1.2% had Gleason 8 or 9. Definitive stage was pT2 in 87.3% of the patients, pT3 in 11.1% and pT4 in 1.4%.…”

Section: Discussionmentioning

confidence: 99%

Histological Findings in Very Low Risk Prostate Cancer Patients Managed with Radical Prostatectomy

et al. 2017

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AbstractObjectives: To describe the histological findings in patients with prostate cancer (PCa) clinically classified as very low risk who underwent treatment with radical prostatectomy (RP). Material and methods: A retrospective observational study was conducted. Clinical records of patients who underwent RP between 2007-2015 who met Epstein criteria for very low risk disease were reviewed. Histological diagnosis was described and analyzed to determine if such criteria predicted very low risk. Results: A total of 609 records were reviewed; 83 (13.6%) met Epstein’s criteria. Mean age was 59 (SD±7) years and median PSA at diagnosis was 5.4 ng/dl (IQR 4.3 – 6.8). Pathology showed a median tumor volume of 4% (IQR 1 – 10%). Gleason score was 3+3 in 55 (66.3%) cases, but 28 (33.7%) were reclassified to a greater score. Two (2.4%) patients were reclassified as pT3a, 80 (96.4%) as pT2 and 1 (1.2%) was found to be pT0. In those subjected to pelvic lymphadenectomy (42.2%) no positive lymph nodes were found. Conclusions: Up to one-third of the patients clinically classified with very low risk PCa had a greater Gleason score. Only 3% had locally advanced tumors, which is comparable to previous studies. Epstein’s criteria seem to be adequate in predicting organ-confined disease.

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Pathologic Findings in Radical Prostatectomy Specimens From Patients Eligible for Active Surveillance With Highly Selective Criteria: A Multicenter Study

Cited by 63 publications

References 25 publications

Can Single Positive Core Prostate Cancer at biopsy be Considered a Low-Risk Disease after Radical Prostatectomy?

Can Single Positive Core Prostate Cancer at biopsy be Considered a Low-Risk Disease after Radical Prostatectomy?

Oncologic outcomes following radical prostatectomy in the active surveillance era

Histological Findings in Very Low Risk Prostate Cancer Patients Managed with Radical Prostatectomy

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