2005
DOI: 10.1097/01.ju.0000169134.28610.66
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Preoperative Prediction of Small Volume Cancer (Less Than 0.5 Ml) in Radical Prostatectomy Specimens

Abstract: The number of positive biopsy sites and the highest percent of adenocarcinoma at any biopsy site are significant predictors of small volume cancer in radical prostatectomy specimens.

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Cited by 51 publications
(36 citation statements)
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“…Thirty-four articles 11,[15][16][17][18][19][20][21][22][23][24][25][26] addressed the specific question of the correlation between small-volume (''microfocal'') cancer on biopsy and pathologic findings, biochemical or clinical progression, or mortality, and 32 of those articles provided original data. 11,[15][16][17][18][19][20][21][22][23][24][25][26] Three of those articles were unique: One referred to the number of positive biopsy sites rather than cores, 42 another examined the relation between the number of positive cores on each side (right or left) and the incidence of extraprostatic spread on that side, 48 and the final article took into account both biopsy cancer volume and presenting PSA density in the presentation of results. 46 Those 3 articles were not considered further, because they did not provide data that were comparable with data from the other 29 articles.…”
Section: Methodsmentioning
confidence: 99%
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“…Thirty-four articles 11,[15][16][17][18][19][20][21][22][23][24][25][26] addressed the specific question of the correlation between small-volume (''microfocal'') cancer on biopsy and pathologic findings, biochemical or clinical progression, or mortality, and 32 of those articles provided original data. 11,[15][16][17][18][19][20][21][22][23][24][25][26] Three of those articles were unique: One referred to the number of positive biopsy sites rather than cores, 42 another examined the relation between the number of positive cores on each side (right or left) and the incidence of extraprostatic spread on that side, 48 and the final article took into account both biopsy cancer volume and presenting PSA density in the presentation of results. 46 Those 3 articles were not considered further, because they did not provide data that were comparable with data from the other 29 articles.…”
Section: Methodsmentioning
confidence: 99%
“…Other biases inherent to retrospective studies also were apparent, particularly in terms of incomplete data ( Table 2); so that the proportion of patients excluded from the final analysis was up to 29%, 37 although, in most studies, this proportion was not clear (Tables 3-6). Final sample sizes were not always given, were limited by the number of patients treated in individual institutions, and usually were small, ranging from 6 patients 29 to 131 patients 42 (median, 34 patients) (Tables 3-6). Not all articles provided complete information on biopsy technique; however, when they did, biopsy strategies and the actual numbers of cores obtained varied (Tables 3-6), and it is possible that a small focus of carcinoma in 1 of 10 biopsies may be less significant than in 1 of 2 biopsies.…”
Section: Limitations On Interpretationmentioning
confidence: 99%
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“…Recent studies have found that the volume of tumor present in biopsies does not correlate with the postoperative radical prostatectomy Gleason score, emphasizing the significance of small-volume, high-grade elements. 12,[33][34][35][36][37][38][39][40][41] Other factors, such as serum PSA levels, clinical stage, the findings of digital rectal examination, and perineural invasion status may help further stratify the risk of biologically aggressive tumor.…”
Section: Discussionmentioning
confidence: 99%
“…Extensive studies have been performed to identify clinically significant cancer using multiple clinical and pathologic parameters, including biopsy information, tumor volume, serum PSA level, PSA velocity and density, free/total PSA ratio, and patient's age at diagnosis. 3,4,12,13 Some authors consider tumor volume to be the single most important factor in predicting cancer progression. 14,15 As there is little information about the anatomic distribution and pathological features of smallvolume prostate cancer, we sought, in this study, to characterize these parameters in small-volume tumors (total volume 0.5 ml or less) in whole-mount prostatectomy specimens.…”
mentioning
confidence: 99%