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
Introducción: El estadío pT0 del cáncer de vejiga implica la ausencia de enfermedad en la pieza de cistectomía radical (CR). El objetivo de este estudio es describir los resultados oncológicos de los pacientes con estadío pT0 posterior a CR por carcinoma urotelial de vejiga. Materiales y métodos: Estudio retrospectivo de pacientes sometidos a CR por cáncer de vejiga, en una sola institución, sin neoadyuvancia, entre junio de 2005 y julio de 2013. Se incluyeron aquellos pacientes con diagnóstico histológico de estadío pT0 pN0. Se estimó la sobrevida global, sobrevida cáncer-específica y sobrevida libre de recidiva con el método de Kaplan-Meier. Resultados: De 254 pacientes cistectomizados, 17 presentaron estadío pT0 pN0 (6,7%). La mediana de edad fue 67 años (rango 49-85), 15 pacientes fueron hombres (88%). Los resultados patológicos posterior a resección transuretral de vejiga (RTUv) fueron 17% pT1 (n=3) y 83% pT2 (n=14). La mediana de tiempo entre RTUv y CR fue 60 días (rango 30- 95). Al 41% se le realizó derivación urinaria tipo Bricker y al 59%, una neovejiga. La mediana de estadía hospitalaria fue 8 días (rango 6-44). Se evidenció adenocarcinoma de próstata en 4 pacientes. La mediana de ganglios resecados fue 6 (rango 2-17). Ningún paciente recibió adyuvancia. La mediana de seguimiento fue 69 meses (rango 5-120). Un paciente presentó recidiva uretral a los 72 meses de la CR. La sobrevida cáncer-específica fue 100%, la sobrevida libre de recaída a 5 años fue 83,3% (intervalo de confianza [IC] de 95%: 53,5-100) y la sobrevida global a 5 años fue 82,4% (IC 95%: 64,7-100). Conclusión: El estadío pT0 del cáncer de vejiga presenta resultados oncológicos más favorables que los estadíos más avanzados. Sin embargo, la posibilidad de recurrencia existe, por lo que no se debe discontinuar el seguimiento de estos pacientes (AU)
Introduction: There are cases in which there is no evidence of disease in the radical cystectomy (RC) specimen (pT0 stage). The purpose of this study is to evaluate oncological outcomes of patients with pT0 bladder cancer after RC, in a single institution, without neo-adjuvant therapy. Materials and methods: Patients who underwent radical cystectomy from June 2005 to July 2013 were reviewed retrospectively. All patients had history of bladder urothelial carcinoma, treated with transurethral resection of the bladder (TURB) and confirmed with pathological analysis. Study variables included TURB pathology, time to RC, and pathologic features. Overall survival (OS), cancer-specific survival (CSS) and recurrence-free survival (RFS) were estimated. Results: RC was performed on 254 patients; 17 patients (6.7%) had pT0N0 stage. Median age was 67 years (range 49-85 years); 15 patients were male (88%). TURB pathology specimens were 17% pT1 (n=3), and 83% pT2 (n=14). Median time between TURB and RC was 60 days (range 30-95). Seven patients (41%) received an ileal conduit, and ten patients (59%) received a neobladder. Median hospital stay was eight days (range 6-44). Prostate adenocarcinoma was found in four (23%) patients. Median resected lymph nodes were six (range 2-17). No patients received adjuvant chemotherapy. Median follow-up was 69 months (range 5-120 months). One patient had a urethral relapse 72 months after RC. There was no cancer-specific mortality. RFS at 5 years was 83.3% (confidence interval [CI] 95%: 53.5-100); OS at 5 years was 82.4% (CI 95%: 64.7-100). Conclusion: pT0 stage after radical cystectomy shows more favorable oncologic outcomes than higher stages. However, cancer recurrence was found in a low number of patients, thus, patient follow-up should be maintained (AU)