PURPOSE: There are numerous reports on the results of watchful waiting or active monitoring protocols for men with low volume, biopsy Gleason grade 6 or less prostate cancer. When counseling patients with low grade prostate cancer about treatment options, it is useful to know the results of surgical treatment in this population. MATERIALS AND METHODS: In a contemporary radical prostatectomy series there were 455 patients with biopsy Gleason grade 3 + 3 prostate cancer and information on the number of positive biopsy cores. Of these men 292 had low volume disease on the basis of 2 or fewer positive cores. RESULTS: Overall 245 of 292 men (84%) with low volume Gleason 3 + 3 prostate cancer on biopsy had organ confined disease. The Gleason score in the prostatectomy specimen was 7 or greater in 78 men (27%), 25 (8%) had extracapsular tumor extension and 29 (10%) had positive surgical margins. In these patients preoperative variables were not reliable predictors of adverse pathological features. CONCLUSIONS: More than a third of Gleason 3 + 3 tumors on biopsy were upgraded in the radical prostatectomy specimen or had other adverse pathological features. Our results suggest that low volume Gleason 3 + 3 prostate cancer is frequently under staged, and that immediate therapy with radical prostatectomy is associated with favorable outcomes.
PURPOSE: There are numerous reports on the results of watchful waiting or active monitoring protocols for men with low volume, biopsy Gleason grade 6 or less prostate cancer. When counseling patients with low grade prostate cancer about treatment options, it is useful to know the results of surgical treatment in this population. MATERIALS AND METHODS: In a contemporary radical prostatectomy series there were 455 patients with biopsy Gleason grade 3 + 3 prostate cancer and information on the number of positive biopsy cores. Of these men 292 had low volume disease on the basis of 2 or fewer positive cores. RESULTS: Overall 245 of 292 men (84%) with low volume Gleason 3 + 3 prostate cancer on biopsy had organ confined disease. The Gleason score in the prostatectomy specimen was 7 or greater in 78 men (27%), 25 (8%) had extracapsular tumor extension and 29 (10%) had positive surgical margins. In these patients preoperative variables were not reliable predictors of adverse pathological features. CONCLUSIONS: More than a third of Gleason 3 + 3 tumors on biopsy were upgraded in the radical prostatectomy specimen or had other adverse pathological features. Our results suggest that low volume Gleason 3 + 3 prostate cancer is frequently under staged, and that immediate therapy with radical prostatectomy is associated with favorable outcomes.
Authors: Barry B McGuire; Brian T Helfand; Shilajit Kundu; Qiaoyan Hu; Jessica A Banks; Phillip Cooper; William J Catalona Journal: BJU Int Date: 2011-11-11 Impact factor: 5.588
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Authors: John W Davis; John F Ward; Curtis A Pettaway; Xuemei Wang; Deborah Kuban; Steven J Frank; Andrew K Lee; Louis L Pisters; Surena F Matin; Jay B Shah; Jose A Karam; Brian F Chapin; John N Papadopoulos; Mary Achim; Karen E Hoffman; Thomas J Pugh; Seungtaek Choi; Patricia Troncoso; Christopher J Logothetis; Jeri Kim Journal: BJU Int Date: 2015-07-04 Impact factor: 5.588
Authors: John W Davis; Jeri Kim; John F Ward; Xuemai Wang; Hiro Nakanishi; R Joseph Babaian; Patricia Troncoso Journal: BJU Int Date: 2009-11-03 Impact factor: 5.588