uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Upper limit of cancer extent on biopsy defining very low-risk prostate cancer
Univ Oxford, Nuffield Dept Surg Sci, Oxford OX3 7DQ, England.;Lund Univ, Helsingborg Hosp, Dept Urol, Lund, Sweden.;Lund Univ, Helsingborg Hosp, Dept Urol, Helsingborg, Sweden..
Univ Uppsala Hosp, Reg Canc Ctr, Uppsala, Sweden..
NYU, Dept Urol, New York, NY USA.;Manhattan Vet Affairs Med Ctr, New York, NY USA..
Univ Toronto, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada..
Show others and affiliations
2015 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 116, no 2, 213-219 p.Article in journal (Refereed) Published
Abstract [en]

Objective To investigate how much Gleason pattern 3 cancer prostate biopsy specimens may contain without an increased risk of undetected more aggressive cancer, compared with the risk for cancers fulfilling the National Comprehensive Cancer Network (NCCN) criteria for very low-risk prostate cancer. Patients and Methods We identified 1286 men aged <70 years in the National Prostate Cancer Register of Sweden who underwent primary radical prostatectomy (RP) for stage T1c or T2 prostate cancer with Gleason pattern <= 3 only, prostate-specific antigen (PSA) level of <10 ng/mL and a PSA density of <0.15 ng/mL/mL. The association between the extent of cancer in the biopsies (the number and proportion of positive cores and the total cancer length in the cores in millimetres) and the likelihood of Gleason pattern 4-5 in the RP specimen was analysed with logistic regression. Results In all, 438 (34%) of the 1286 men had Gleason pattern 4-5 in the RP specimen. Increasing number and proportion of positive biopsy cores, as well as increasing biopsy cancer length were both significantly associated with increased risk of upgrading at RP in univariable analysis, but in multivariable analysis only biopsy cancer length remained significant. The 684 men with stage T1c and < 8 mm cancer had similar risk of upgrading regardless of whether the number of positive biopsy cores was 1-2 or 3-4 (28% vs 27% risk); upgrading was more common among the remaining men (40%, P < 0.01). Conclusions Men aged < 70 years with stage T1c prostate cancer and 3-4 biopsy cores with Gleason pattern 3 are not more likely to have undetected Gleason pattern 4-5 cancer than men with 1-2 cores with cancer, provided that the total biopsy cancer length is < 8 mm. We propose that the definition of very low-risk prostate cancer is widened accordingly.

Place, publisher, year, edition, pages
2015. Vol. 116, no 2, 213-219 p.
Keyword [en]
prostatic neoplasms, categorisation, biopsy, pathology
National Category
Cancer and Oncology
URN: urn:nbn:se:uu:diva-304587DOI: 10.1111/bju.12874ISI: 000358529500015PubMedID: 25053197OAI: oai:DiVA.org:uu-304587DiVA: diva2:1033412
Available from: 2016-10-06 Created: 2016-10-06 Last updated: 2016-10-06

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
In the same journal
BJU International
Cancer and Oncology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

ReferencesLink to record
Permanent link

Direct link