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969 Stage T0 prostate cancer after robot-assisted laparoscopic radical prostatectomy. Preoperative clinicopathologic characteristics and oncologic outcomes
969 - Stage T0 prostate cancer after robot-assisted laparoscopic radical prostatectomy. Pre... Page 1 of 2
e969 Stage T0 prostate cancer after robot-assisted laparoscopic radical prostatectomy. Preoperative clinicopathologic characteristics and oncologic outcomes Labanaris A.P., Zugor V., Wagner C., Lange P., Witt J.H. Prostate Center Northwest, St. Antonius Medical Center, Gronau, Germany, Dept. of Urology and Pediatric Urology, Gronau, Germany INTRODUCTION & OBJECTIVES: Robot-assisted laparoscopic radical prostatectomy (RALP) is a well established therapy for patients with prostate cancer (PCa). In a small cohort of patients an absence of PCa in the prostate specimen can be evident. These cases are classified as stage T0. The aim of this study is to evaluate the preoperative clinicopathologic characteristics and oncologic outcomes of patients classified as T0 despite prior biopsy proven PCa. MATERIAL & METHODS: The records of N=3000 men who underwent RALP from February 2006 to August 2011 were retrospectively reviewed. A total of N=21 patients (0.7%) were identified as having a T0 PCa and were included in the study. None of the patients were diagnosed after transurethral prostate resection or prostatectomy and none had received neoadjuvant hormonal treatment. The parameters analysed included age, prostate specific antigen (PSA), prostate size, clinical stage, number of biopsy cores performed, number of positive cores, Gleason score, histology of the RALP specimen, postoperative PSA assay and evidence of clinical or biochemical progression follow-up period. RESULTS: The median age of the patients was 62.1 years old (50-73 years old), the median PSA was 8.1 ng/ml (2.1-19 ng/ml), the median prostate size was 58.9 gr. (35-104 gr.) and the clinical stage was T1c in N=16 patients (76.1%), T2a in N=4 patients (19.1%) and T2b in N=1 patient (4.8%). The median number of biopsy cores performed was 12.2 (6-24 cores) and the median number of number of positive cores was 1.2 (1-3 cores). The preoperative Gleason score was Gleason 6 in N=18 patients (85.7%), Gleason 7 in N=2 patients (9.5%) and Gleason
file://F:\RamShankar\April\04-05-12\Cip\Sour\969.html
4/7/2012
969 - Stage T0 prostate cancer after robot-assisted laparoscopic radical prostatectomy. Pre... Page 2 of 2
e969a 8 in N=1 patient (4.8%). Examination of the RALP specimens were performed by a highly experienced Urologic Pathologist (>3500 PCa specimens examinations performed) blinded to patient clinical data. The histology of the RALP specimen was in all cases T0. The median follow-up period of the patients was 14.1 months (3-34 months). All patients had undetectable PSA levels throughout our follow-up period and no patient presented with evidence of clinical or biochemical progression. Although advised, none of the patients performed a DNA based tissue analysis of the biopsy cores and prostate specimen. CONCLUSIONS: Interestingly only one patient had preoperative a high-grade tumour with the rest of them exhibiting an insignificant PCa. After biopsy proven PCa an absence of cancer in the prostatectomy specimen poses a large challenge to the involved Pathologist, Urologist and patient as well. Although none of the patients had a biochemical or clinical relapse during follow-up period there might be legal repercussions that justify DNA based tissue analysis.
file://F:\RamShankar\April\04-05-12\Cip\Sour\969.html
4/7/2012
e969 Stage T0 prostate cancer after robot-assisted laparoscopic radical prostatectomy. Preoperative clinicopathologic characteristics and oncologic outcomes Labanaris A.P., Zugor V., Wagner C., Lange P., Witt J.H. Prostate Center Northwest, St. Antonius Medical Center, Gronau, Germany, Dept. of Urology and Pediatric Urology, Gronau, Germany INTRODUCTION & OBJECTIVES: Robot-assisted laparoscopic radical prostatectomy (RALP) is a well established therapy for patients with prostate cancer (PCa). In a small cohort of patients an absence of PCa in the prostate specimen can be evident. These cases are classified as stage T0. The aim of this study is to evaluate the preoperative clinicopathologic characteristics and oncologic outcomes of patients classified as T0 despite prior biopsy proven PCa. MATERIAL & METHODS: The records of N=3000 men who underwent RALP from February 2006 to August 2011 were retrospectively reviewed. A total of N=21 patients (0.7%) were identified as having a T0 PCa and were included in the study. None of the patients were diagnosed after transurethral prostate resection or prostatectomy and none had received neoadjuvant hormonal treatment. The parameters analysed included age, prostate specific antigen (PSA), prostate size, clinical stage, number of biopsy cores performed, number of positive cores, Gleason score, histology of the RALP specimen, postoperative PSA assay and evidence of clinical or biochemical progression follow-up period. RESULTS: The median age of the patients was 62.1 years old (50-73 years old), the median PSA was 8.1 ng/ml (2.1-19 ng/ml), the median prostate size was 58.9 gr. (35-104 gr.) and the clinical stage was T1c in N=16 patients (76.1%), T2a in N=4 patients (19.1%) and T2b in N=1 patient (4.8%). The median number of biopsy cores performed was 12.2 (6-24 cores) and the median number of number of positive cores was 1.2 (1-3 cores). The preoperative Gleason score was Gleason 6 in N=18 patients (85.7%), Gleason 7 in N=2 patients (9.5%) and Gleason
file://F:\RamShankar\April\04-05-12\Cip\Sour\969.html
4/7/2012
969 - Stage T0 prostate cancer after robot-assisted laparoscopic radical prostatectomy. Pre... Page 2 of 2
e969a 8 in N=1 patient (4.8%). Examination of the RALP specimens were performed by a highly experienced Urologic Pathologist (>3500 PCa specimens examinations performed) blinded to patient clinical data. The histology of the RALP specimen was in all cases T0. The median follow-up period of the patients was 14.1 months (3-34 months). All patients had undetectable PSA levels throughout our follow-up period and no patient presented with evidence of clinical or biochemical progression. Although advised, none of the patients performed a DNA based tissue analysis of the biopsy cores and prostate specimen. CONCLUSIONS: Interestingly only one patient had preoperative a high-grade tumour with the rest of them exhibiting an insignificant PCa. After biopsy proven PCa an absence of cancer in the prostatectomy specimen poses a large challenge to the involved Pathologist, Urologist and patient as well. Although none of the patients had a biochemical or clinical relapse during follow-up period there might be legal repercussions that justify DNA based tissue analysis.
file://F:\RamShankar\April\04-05-12\Cip\Sour\969.html
4/7/2012