Evaluation of pT0 prostate cancer in patients undergoing radical prostatectomy

Daniel M. Moreira, Boris Gershman, Laureano J. Rangel, Stephen A. Boorjian, Robert Houston Thompson, Igor Frank, Matthew K. Tollefson, Matthew T. Gettman, Robert Jeffrey Karnes

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Objective: To evaluate the incidence, predictors and oncological outcomes of pT0 prostate cancer (PCa). Methods: We conducted a retrospective analysis of 20 222 patients undergoing radical prostatectomy (RP) for PCa at the Mayo Clinic between 1987 and 2012. Disease recurrence was defined as follow-up PSA >0.4 ng/mL or biopsy-proven local recurrence. Systemic progression was defined as development of metastatic disease on imaging. Comparisons of baseline characteristics between pT0 and non-pT0 groups were carried out using chi-squared tests. Recurrence-free survival was estimated using the Kaplan–Meier method and compared using the log-rank test. Results: A total of 62 patients (0.3%) had pT0 disease according to the RP specimen. In univariable analysis, pT0 disease was significantly associated with older age (P = 0.045), lower prostate-specific antigen (PSA; P = 0.002), lower clinical stage (P < 0.001), lower biopsy Gleason score (P = 0.042), and receipt of preoperative transurethral resection, hormonal and radiation therapies (all P < 0.001). In multivariable analysis, lower PSA levels, lower Gleason score, and receipt of preoperative treatment were independently associated with pT0 (all P < 0.05). Seven patients (11%) with pT0 PCa developed disease recurrence over a median follow-up of 10.9 years. All seven patients had preoperative treatment(s) and three had recurrence with a PSA doubling time of <9 months. Compared with non-pT0 disease, pT0 disease was associated with longer recurrence-free survival (P < 0.05). Only one (1.6%) patient with pT0 disease developed systemic progression. Conclusions: pT0 stage PCa is a rare phenomenon and is associated with receipt of preoperative treatment and features of low-risk PCa. Although pT0 has a very favourable prognosis, some men, especially those who received preoperative treatment, experience a small but non-negligible risk of disease recurrence and systemic progression.

Original languageEnglish (US)
Pages (from-to)379-383
Number of pages5
JournalBJU International
Volume118
Issue number3
DOIs
StatePublished - Sep 1 2016

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Keywords

  • disease-free survival
  • prostate cancer
  • prostatectomy
  • PSA

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

Cite this

Moreira, D. M., Gershman, B., Rangel, L. J., Boorjian, S. A., Thompson, R. H., Frank, I., Tollefson, M. K., Gettman, M. T., & Karnes, R. J. (2016). Evaluation of pT0 prostate cancer in patients undergoing radical prostatectomy. BJU International, 118(3), 379-383. https://doi.org/10.1111/bju.13266