Minimal or No Cancer in Radical Prostatectomy Specimens

Goldstein, Neal S.; Bégin, Louis R.; Grody, Wayne W.; Novak, Jessica; Qian, Junqi; Bostwick, David G.

doi:10.1097/00000478-199509000-00003

Cited by 88 publications

(35 citation statements)

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“…Rarely, there is little or no residual cancer despite exhaustive histological evaluation of the entire specimen [1,3]. In our original description of the 'vanishing cancer phenomenon' we and others described 13 patients, including two in whom no residual cancer was identified [3]. A subsequent report confirmed this clinically important finding [1].…”

Section: Introductionmentioning

confidence: 82%

“…The overdiagnosis of prostate cancer is also a concern, with an incidence of 21% in small foci in TURP specimens between 1960 and 1970 [5]. Genotypic analysis to verify patient identity in cases of 'vanishing' cancer [3] is becoming increasingly popular, and it appears to be prudent to reassure patients (DG Bostwick, unpublished observations).…”

Section: Discussionmentioning

confidence: 99%

“…In all, 38 cases of pT0 cancer were identified, including one previously described [3]. We reviewed all diagnostic biopsy and RP specimens from each case, and the following were recorded: patient age, previous clinical history, preoperative serum PSA level, DRE results, clinical stage, biopsy grade, biopsy length, cancer length on biopsy, percentage cancer on biopsy, prostate weight, number of RP slides examined, preoperative therapy, date of last PSA, interval to last follow-up or death, and status at last follow-up.…”

Section: Methodsmentioning

confidence: 99%

“…There has also been a parallel decline in the volume of residual cancer in radical prostatectomy (RP) samples [1]. Rarely, there is little or no residual cancer despite exhaustive histological evaluation of the entire specimen [1,3]. In our original description of the 'vanishing cancer phenomenon' we and others described 13 patients, including two in whom no residual cancer was identified [3].…”

Section: Introductionmentioning

confidence: 99%

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‘Vanishing’ prostate cancer in radical prostatectomy specimens: incidence and long‐term follow‐up in 38 cases

Bostwick

2004

BJU International

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OBJECTIVE To determine the incidence and long‐term follow‐up of the ‘vanishing cancer’ phenomenon, as complete sampling of some radical prostatectomy (RP) specimens reveals no residual cancer. MATERIALS AND METHODS The Mayo Clinic prostate cancer RP database for 1966–1995 was searched for all cases in which there was no residual adenocarcinoma (pathological stage pT0). Each case was confirmed by a review of all tissue specimen slides. Various clinical and pathological features were evaluated, and the follow‐up obtained for all patients. RESULTS Among 6843 RPs there were 38 in which no residual cancer was identified despite careful sampling. There was a 10‐fold decline in the incidence of this finding, from 2.1% before 1980 to 0.2% in 1993–95; this decline appeared to be caused by a decrease in the frequency of diagnosis of cancer by transurethral resection from > 10% before 1990 to < 2% in 1993–95. The mean (range) age of the patients was 63 (38–75) years. All cancers on biopsy or transurethral resection were well or moderately differentiated; clinical stages included T1a (42% of cases), T1b (45%) and T2 (13%). Six patients had a nerve‐sparing RP, all after 1990. The mean follow‐up was 9.6 (1.0–28.5) years, and there were no recurrences of cancer; the serum prostate specific antigen concentration remained at < 0.2 ng/mL in surviving patients. Six patients (16%) died from intercurrent disease. CONCLUSIONS The incidence of ‘vanishing cancer’ declined between 1966 and 1995, probably as a result of the decline in the use of transurethral resection, occurring in 0.2% of RPs. The prognosis in such patients is excellent, indicating that there is no apparent clinical significance to microscopic foci of cancer that remain undetected after reasonably complete pathological sampling. The inability to identify cancer in a prostate removed for biopsy‐confirmed carcinoma does not indicate technical failure.

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Section: Introductionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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‘Vanishing’ prostate cancer in radical prostatectomy specimens: incidence and long‐term follow‐up in 38 cases

Bostwick

2004

BJU International

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“…This scenario influences treatment and can lead to an ambiguous management strategy by clinicians. In the literature, vanishing tumors of the prostate have been reported for the past few years, the incidence of which is on a decline (15,16). The vanishing tumor phenomenon has been recently described in thyroid gland by some authors (17,18).…”

Section: Original Articlementioning

confidence: 99%