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- Title
Evaluation of pT0 prostate cancer in patients undergoing radical prostatectomy.
- Authors
Moreira, Daniel M.; Gershman, Boris; Rangel, Laureano J.; Boorjian, Stephen A.; Thompson, Robert Houston; Frank, Igor; Tollefson, Matthew K.; Gettman, Matthew T.; Karnes, Robert Jeffrey
- Abstract
Objective To evaluate the incidence, predictors and oncological outcomes of pT0 prostate cancer ( PCa). Methods We conducted a retrospective analysis of 20 222 patients undergoing radical prostatectomy ( RP) for PCa at the Mayo Clinic between 1987 and 2012. Disease recurrence was defined as follow-up PSA >0.4 ng/mL or biopsy-proven local recurrence. Systemic progression was defined as development of metastatic disease on imaging. Comparisons of baseline characteristics between pT0 and non- pT0 groups were carried out using chi-squared tests. Recurrence-free survival was estimated using the Kaplan-Meier method and compared using the log-rank test. Results A total of 62 patients (0.3%) had pT0 disease according to the RP specimen. In univariable analysis, pT0 disease was significantly associated with older age ( P = 0.045), lower prostate-specific antigen ( PSA; P = 0.002), lower clinical stage ( P < 0.001), lower biopsy Gleason score ( P = 0.042), and receipt of preoperative transurethral resection, hormonal and radiation therapies (all P < 0.001). In multivariable analysis, lower PSA levels, lower Gleason score, and receipt of preoperative treatment were independently associated with pT0 (all P < 0.05). Seven patients (11%) with pT0 PCa developed disease recurrence over a median follow-up of 10.9 years. All seven patients had preoperative treatment(s) and three had recurrence with a PSA doubling time of <9 months. Compared with non- pT0 disease, pT0 disease was associated with longer recurrence-free survival ( P < 0.05). Only one (1.6%) patient with pT0 disease developed systemic progression. Conclusions pT0 stage PCa is a rare phenomenon and is associated with receipt of preoperative treatment and features of low-risk PCa. Although pT0 has a very favourable prognosis, some men, especially those who received preoperative treatment, experience a small but non-negligible risk of disease recurrence and systemic progression.
- Subjects
PROSTATE cancer; PROSTATECTOMY; PROSTATE surgery; METASTASIS; KAPLAN-Meier estimator
- Publication
BJU International, 2016, Vol 118, Issue 3, p379
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/bju.13266