ABSTRACT
Objective To analyze the clinical and pathological characteristics and prognosis of stage pT0 prostate cancer patients after radical prostatectomy.Methods From November 2004 to May 2017,eight patients who underwent radical prostatectomy and postoperatively diagnosed with pT0 were retrospectively evaluated.The patients aged 63-75 years (mean 69.1 years),with PSA 2.26-14.10 ng/ml(mean 6.10 ng/ml),prostate volume 30.3-72.1 ml (mean 52.1 ml).Exclusion criteria included patients undergoing neoadjuvant hormone therapy or TURP before the operation.Stage pT0 prostate cancer was defined as no evidence of residual tumor in radical prostatectomy specimen from the patient in whom biopsy-proven prostate carcinoma was histologically diagnosed.The clinical and pathological data were reviewed and follow-up was performed for stage pT0 prostate cancer patients.Biochemical progression was defined as postoperative PSA greater than 2 ng/ml for twice.The patients were followed-up.Results Eight patients (1.1％) were postoperatively diagnosed with prostate cancer of pT0 stage.After radical prostatectomy specimen was reexamined by an uropathological expert,small residual tumor(2mm) was found in left peripheral zone of the prostate in one patient.The average follow-up duration was 75 months for this 8 pT0 patients.One patient died of pulmonary embolism after 5 days of the surgery.No patient had evidence of biochemical progression.No biochemical recurrence survival rate and cancer-specific survival rate was 100％ (7/7) and overall survival rate was 87.5％ (7/8) for pT0 prostate cancer patients.Conclusions For patients who were biopsy-proven prostate cancer without neoadjuvant hormone therapy,stage pT0 was a rare pathological phenomenon.Those patients had a very favourable oncological prognosis.
ABSTRACT
ObjectiveTo compare the clinical characteristic and postoperative histopathological parameters in different prostate size and to assess the effect of prostate volume on histopathological outcomes in patients after laparoscopic radical prostatectomy. MethodsTwo hundred and sixteen patients from 2006 to 2011 who were proved prostatic carcinoma by biopsy and performed laparoscopic radical prostatectomy wewe retrospectively evaluated.All patients were divided into the small group ( ＜ 30 ml,103 cases),intermediate group(30 -60 ml,71 cases) and large group ( ＞60 ml,42 cases) according to prostate volume.Clinical variables included age,body mass index (BMI),preoperative PSA level,prostate volume,percentage of positive needles,clinical stage,and biopsy Gleason score (GS).Histopathological parameters included pathological GS,upgrading or not compared to biopsy GS,pathological stage and surgical margins status.Preoperative clinical variables and postoperative histopatholgogical parameters were compared among the 3 prostate groups. ResultsPatients with smaller prostates had lower PSA levels than those with intermediate and larger prostates (P =0.000).They also had worse histopathological outcomes such as pathological GS ( P =0.034 ),upgrading of GS ( P =0.037 ),and pathological stage ( P =0.025 ).35.0％ of patients in smaller prostate group had a positive surgical margin compare to 33.8％ and 19.0％ in intermediate and larger prostate groups,but there was no significant difference (P =0.152).ConclusionMen with smaller prostate may have more high-grade cancer and more advanced disease after laparoscopic radical prostatectomy.