To evaluate the incidence, predictors and oncologic outcomes of pT0 prostate cancer (PCa).
Retrospective analysis of 20,222 men undergoing RP for PCa at Mayo Clinic from 1987 to 2012. Disease recurrence was defined as follow-up prostate-specific antigen (PSA) >0.
4ng/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 were done with chi-square and tests. Recurrence-free survival was estimated using the Kaplan-Meier method and compared with log-rank test.
A total of 62 (0.3%) men had pT0 in the RP specimen. In univariable analysis, pT0 was significantly associated with older age (P=0.045), lower 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 (11%) pT0 men developed disease recurrence over a median follow-up of 10.9 years. All 7 patients had preoperative treatment(s) and 3 had recurrence with a PSA doubling time <9 months. Compared to non-pT0, pT0 was associated with longer recurrence-free survival (P<0.05). Only 1 (1.6%) pT0 man developed systemic progression.
pT0 PCa is a rare phenomenon and is associated with receipt of preoperative treatment and features of low risk PCa. Although pT0 has a very favorable prognosis, some men, especially those who received preoperative treatment, experience a small but non-negligible risk of disease recurrence and systemic progression. This article is protected by copyright All rights reserved.
BJU international 2015 Aug 25 [Epub ahead of print]
Daniel M Moreira, Boris Gershman, Laureano J Rangel, Stephen A Boorjian, R Houston Thompson, Igor Frank, Matthew K Tollefson, Matthew T Gettman, R Jeffrey Karnes
Department of Urology, Mayo Clinic, Rochester, MN , Department of Urology, Mayo Clinic, Rochester, MN , Division of Biomedical Statistics and Informatics, Mayo Foundation for Medical Education and Research, Mayo Clinic, Rochester, MN , Department of Urology, Mayo Clinic, Rochester, MN , Department of Urology, Mayo Clinic, Rochester, MN , Department of Urology, Mayo Clinic, Rochester, MN , Department of Urology, Mayo Clinic, Rochester, MN , Department of Urology, Mayo Clinic, Rochester, MN , Department of Urology, Mayo Clinic, Rochester, MN