Residual Tumor Potentially Left Behind After Local Ablation Therapy in Prostate Adenocarcinoma

No AccessJournal of UrologyAdult Urology1 Jun 2008Residual Tumor Potentially Left Behind After Local Ablation Therapy in Prostate Adenocarcinomais accompanied byFocal Prostate Therapy Ghil Suk Yoon, Wenle Wang, Adeboye O. Osunkoya, Zhaoli Lane, Alan W. Partin, and Jonathan I. Epstein Ghil Suk YoonGhil Suk Yoon Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland , Wenle WangWenle Wang Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland , Adeboye O. OsunkoyaAdeboye O. Osunkoya Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland , Zhaoli LaneZhaoli Lane Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland , Alan W. PartinAlan W. Partin Department of Urology, Johns Hopkins Medical Institutions, Baltimore, Maryland , and Jonathan I. EpsteinJonathan I. Epstein Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland Department of Urology, Johns Hopkins Medical Institutions, Baltimore, Maryland View All Author Informationhttps://doi.org/10.1016/j.juro.2008.01.114AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examined contralateral prostate cancer potentially left behind by focal therapy. Materials and Methods: We investigated 100 completely embedded radical prostatectomy specimens in which needle biopsy predicted limited disease (less than 3 positive cores, 50% or less involvement of any positive core, Gleason score 6 or less) and all positive needle cores were unilateral. Clinical stage was T1c in 85 and T2a in 15 cases with the palpable lesion on the positive biopsy side. Results: There was 1 positive core in 66 cases. On average 13.9% of each positive core was involved with tumor. The mean number of separate tumor nodules per radical prostatectomy was 2.9. In 65 radical prostatectomy specimens there was some tumor contralateral to the positive biopsy side. Total tumor volume in the radical prostatectomy contralateral to the positive biopsy side averaged 0.2 cm3 (largest 1.3). In 23 cases contralateral tumor volume was greater than biopsy positive side tumor volume. There were 13 cases in which more than 0.5 cm3 cancer was contralateral to the positive biopsy and 7 with predominantly anterior tumor. Volume contralateral to positive biopsy side could not be predicted by the number of positive cores (1 vs 2) or maximum percent of the core involved. Gleason pattern 4, extraprostatic extension or positive margins were seen contralateral to the positive biopsy side in 13, 1 and 2 cases, respectively. Conclusions: In a highly selected population with limited unilateral biopsy cancer, tumor contralateral to the positive biopsy side at radical prostatectomy is typically small. However, 20% of radical prostatectomy specimens had some contralateral adverse pathology in terms of size, extraprostatic extension, grade or margins. References 1 : Predictive value of prostatic adenocarcinoma after a negative prostate biopsy. BJU Int2006; 98: 986. Google Scholar 2 : Increasing incidence of minimal residual cancer in radical prostatectomy specimens. Am J Surg Pathol1997; 21: 174. Google Scholar 3 : Multiple cancers in the prostate: Morphologic features of clinically recognized versus incidental tumors. Cancer1992; 70: 2313. Google Scholar 4 : Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA1994; 271: 368. 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Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMatoso A, Hassan O, Petrozzino F, Rao B, Carter H and Epstein J (2015) Radical Prostatectomy Findings in Men on Active Surveillance: Variable Findings Dependent on Reason for Surgery and Entry CriteriaJournal of Urology, VOL. 194, NO. 3, (685-689), Online publication date: 1-Sep-2015.Mouraviev V (2010) Editorial CommentJournal of Urology, VOL. 184, NO. 5, (1969-1970), Online publication date: 1-Nov-2010.Robinson B and Epstein J (2010) Intraductal Carcinoma of the Prostate Without Invasive Carcinoma on Needle Biopsy: Emphasis on Radical Prostatectomy FindingsJournal of Urology, VOL. 184, NO. 4, (1328-1333), Online publication date: 1-Oct-2010.Epstein J (2009) An Update of the Gleason Grading SystemJournal of Urology, VOL. 183, NO. 2, (433-440), Online publication date: 1-Feb-2010.Duffield A, Lee T, Miyamoto H, Carter H and Epstein J (2009) Radical Prostatectomy Findings in Patients in Whom Active Surveillance of Prostate Cancer FailsJournal of Urology, VOL. 182, NO. 5, (2274-2279), Online publication date: 1-Nov-2009.Related articlesJournal of Urology17 Apr 2008Focal Prostate Therapy Volume 179 Issue 6 June 2008 Page: 2203-2206 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsprostatic neoplasmscryosurgeryprostatectomyMetrics Author Information Ghil Suk Yoon Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Wenle Wang Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Adeboye O. Osunkoya Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Zhaoli Lane Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Alan W. Partin Department of Urology, Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Jonathan I. Epstein Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland Department of Urology, Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Expand All Advertisement PDF downloadLoading ...