INTRODUCTION: To determine clinical and biopsy features with predictive capacity to identify pathologically insignificant prostate cancer (pIPCa). MATERIAL AND METHODS: pIPCa was defined as cancer volume <0.5 cm(3) and a Gleason score (GS) of <or=6 in radical prostatectomy (RP) specimens. Clinical and biopsy parameters were studied as predictors of pIPCa and validated by applying them to d'Amico's low-risk cases: T1c-T2a, prostate-specific antigen (PSA) <10 and biopsy GS <or=6. Appropriate cut-offs were selected. RESULTS: 280 patients were evaluated; 11.8% (33) had pIPCa, increasing to 23% in low-risk cases. In patients fulfilling d'Amico's low-risk criteria, variables significantly different in pIPCa were: volume, number of positive cylinders (NPC), percentage of positive cylinders (%PC), percentage of the most affected cylinder (%MAC) and uni/bilaterality. In these cases, volume and the NPC increased as independent variables on logistic regression and when adding a volume threshold of 45 cm(3) and 1 positive core, specificity reached 95.8%. CONCLUSIONS: The incidence of pIPCa in RP specimens is relevant, especially in low-risk cases. Prostate volume and NPC are independent predictors of pIPCa. We propose a simple predictive model by adding the features of 1 positive core and volume >or=45 cm(3) to d'Amico's criteria. This allows to preoperatively distinguish between patients that most probably would benefit from radical treatment and patients that might be offered active surveillance. Copyright (c) 2010 S. Karger AG, Basel.
INTRODUCTION: To determine clinical and biopsy features with predictive capacity to identify pathologically insignificant prostate cancer (pIPCa). MATERIAL AND METHODS:pIPCa was defined as cancer volume <0.5 cm(3) and a Gleason score (GS) of <or=6 in radical prostatectomy (RP) specimens. Clinical and biopsy parameters were studied as predictors of pIPCa and validated by applying them to d'Amico's low-risk cases: T1c-T2a, prostate-specific antigen (PSA) <10 and biopsy GS <or=6. Appropriate cut-offs were selected. RESULTS: 280 patients were evaluated; 11.8% (33) had pIPCa, increasing to 23% in low-risk cases. In patients fulfilling d'Amico's low-risk criteria, variables significantly different in pIPCa were: volume, number of positive cylinders (NPC), percentage of positive cylinders (%PC), percentage of the most affected cylinder (%MAC) and uni/bilaterality. In these cases, volume and the NPC increased as independent variables on logistic regression and when adding a volume threshold of 45 cm(3) and 1 positive core, specificity reached 95.8%. CONCLUSIONS: The incidence of pIPCa in RP specimens is relevant, especially in low-risk cases. Prostate volume and NPC are independent predictors of pIPCa. We propose a simple predictive model by adding the features of 1 positive core and volume >or=45 cm(3) to d'Amico's criteria. This allows to preoperatively distinguish between patients that most probably would benefit from radical treatment and patients that might be offered active surveillance. Copyright (c) 2010 S. Karger AG, Basel.
Authors: Julie C Bulman; Robert Toth; Amish D Patel; B Nicolas Bloch; Colm J McMahon; Long Ngo; Anant Madabhushi; Neil M Rofsky Journal: Radiology Date: 2012-01 Impact factor: 11.105
Authors: Antonio B Porcaro; Alessandro Tafuri; Marco Sebben; Giovanni Novella; Tania Processali; Marco Pirozzi; Nelia Amigoni; Riccardo Rizzetto; Aliasger Shakir; Arianna Mariotto; Matteo Brunelli; Maria Angela Cerruto; Giovanni Enrico Cacciamani; Filippo Migliorini; Salvatore Siracusano; Walter Artibani Journal: World J Urol Date: 2019-06-01 Impact factor: 4.226