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World Journal of Urology

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01-12-2014 | Original Article

Insignificant disease among men with intermediate-risk prostate cancer

Authors: Sung Kyu Hong, Emily Vertosick, Daniel D. Sjoberg, Peter T. Scardino, James A. Eastham

Published in: World Journal of Urology | Issue 6/2014

Abstract

Purpose

A paucity of data exists on the insignificant disease potentially suitable for active surveillance (AS) among men with intermediate-risk prostate cancer (PCa). We tried to identify pathologically insignificant disease and its preoperative predictors in men who underwent radical prostatectomy (RP) for intermediate-risk PCa.

Methods

We analyzed data of 1,630 men who underwent RP for intermediate-risk disease. Total tumor volume (TTV) data were available in 332 men. We examined factors associated with classically defined pathologically insignificant cancer (organ-confined disease with TTV ≤0.5 ml with no Gleason pattern 4 or 5) and pathologically favorable cancer (organ-confined disease with no Gleason pattern 4 or 5) potentially suitable for AS. Decision curve analysis was used to assess clinical utility of a multivariable model including preoperative variables for predicting pathologically unfavorable cancer.

Results

In the entire cohort, 221 of 1,630 (13.6 %) total patients had pathologically favorable cancer. Among 332 patients with TTV data available, 26 (7.8 %) had classically defined pathologically insignificant cancer. Between threshold probabilities of 20 and 40 %, decision curve analysis demonstrated that using multivariable model to identify AS candidates would not provide any benefit over simply treating all men who have intermediate-risk disease with RP.

Conclusion

Although a minority of patients with intermediate-risk disease may harbor pathologically favorable or insignificant cancer, currently available conventional tools are not sufficiently able to identify those patients.

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Title: Insignificant disease among men with intermediate-risk prostate cancer
Authors: Sung Kyu Hong
Emily Vertosick
Daniel D. Sjoberg
Peter T. Scardino
James A. Eastham
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 6/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1413-3

At a glance: The STEP trials

Springer Medicine

Insignificant disease among men with intermediate-risk prostate cancer

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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