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Journal of Oncology
Volume 2012 (2012), Article ID 645146, 6 pages
http://dx.doi.org/10.1155/2012/645146
Research Article

Can a Gleason 6 or Less Microfocus of Prostate Cancer in One Biopsy and Prostate-Specific Antigen Level <10 ng/mL Be Defined as the Archetype of Low-Risk Prostate Disease?

1Department of Urology, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy
2Department of Urology, Fidenza Hospital, Parma, Italy
3Laboratories of Quantitative Medicine, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy
4Department of Pathology, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy
5Service of Statistics, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy

Received 21 March 2012; Accepted 21 April 2012

Academic Editor: M. Roach

Copyright © 2012 Gianluigi Taverna et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Prostate cancer (PC) remains a cause of death worldwide. Here we investigate whether a single microfocus of PC at the biopsy (graded as Gleason 6 or less, ≤5% occupancy) and the PSA <10 ng/mL can define the archetype of low-risk prostate disease. 4500 consecutive patients were enrolled. Among them, 134 patients with a single micro-focus of PC were followed up, and the parameters influencing the biochemical relapse (BR) were analysed. Out of 134 patients, 94 had clinically significant disease, specifically in 74.26% of the patients with PSA <10 ng/mL. Positive surgical margins and the extracapsular invasion were found in 29.1% and 51.4% patients, respectively. BR was observed in 29.6% of the patients. Cox regression evidenced a correlation between the BR and Gleason grade at the retropubic radical prostatectomy (RRP), capsular invasion, and the presence of positive surgical margins. Multivariate regression analysis showed a statistically significant correlation between the presence of surgical margins at the RRP and BR. Considering a single micro-focus of PC at the biopsy and PSA serum level <10 ng/mL, clinically significant disease was found in 74.26% patients and only positive surgical margins are useful for predicting the BR.