Stage pT0 Prostate Cancer: A Single-Center Study and Literature Review

Abstract

Objective:To report our experience with biopsy positive T0 prostate cancer (PCa) and perform a literature review to determine the frequency, clinical outcomes, and predictors of pT0 PCa after radical prostatectomy (RP).Materials and Methods:The records of 497 patients who underwent robot-assisted RP at our institution between 2015 and 2020 were retrospectively reviewed. No patients were diagnosed after the transurethral prostate resection or received preoperative hormone therapy. Clinicopathological features including age, prostate-specific antigen (PSA), body mass index, digital rectal examination, biopsy results, clinical T stage, D’Amico risk, prostate weight, prostatectomy pathology, and follow-up data were analyzed.Results:Overall, 3 patients were classified as pT0 on pathologic examination of the RP. The biopsy re-evaluation revealed that 1 patient did not have PCa. Subsequently, the entire RP specimens were re-analyzed, wherein 2 cases were signed out with no identified carcinoma. The incidence of the pT0 PCa was 0.4% in our series. The median age of patients was 64 years. The median PSA was 14.27 ng/mL. Biopsy Gleason score of 2 patients was reported as 3 + 3. All patients had a tumor in only one core and all were in clinical stage T1c. No biochemical recurrence was found in a mean 21-month follow-up. Eleven studies were identified involving 26,228 patients, wherein 122 (0.46%) were reported with pT0 cases. Most patients with stage pT0 have been reported to have a Gleason score of <7, only one positive core biopsy, and a tumor length of <2 mm.Conclusion:Patients with a Gleason score of 6 and tumors in a single core and length of <2 mm in the biopsy should be informed about the risk of stage pT0.

Keywords

• prostate cancer
• residual cancer
• surgical pathology
• prostatectomy