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Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?

OBJECTIVE: The aim of active surveillance of early prostate cancer is to individualize therapy by selecting for curative treatment only patients with significant cancer. Epstein’s criteria for prediction of clinically insignificant cancer in surgical specimens are widely used. Epstein’s criterion “n...

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Autores principales: Billis, Athanase, Quintal, Maisa M.Q, Freitas, Leandro L.L, Costa, Larissa B. E., Ferreira, Ubirajara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Urologia 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752103/
https://www.ncbi.nlm.nih.gov/pubmed/26005981
http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.02.26
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author Billis, Athanase
Quintal, Maisa M.Q
Freitas, Leandro L.L
Costa, Larissa B. E.
Ferreira, Ubirajara
author_facet Billis, Athanase
Quintal, Maisa M.Q
Freitas, Leandro L.L
Costa, Larissa B. E.
Ferreira, Ubirajara
author_sort Billis, Athanase
collection PubMed
description OBJECTIVE: The aim of active surveillance of early prostate cancer is to individualize therapy by selecting for curative treatment only patients with significant cancer. Epstein’s criteria for prediction of clinically insignificant cancer in surgical specimens are widely used. Epstein’s criterion “no single core with >50% cancer” has no correspondence in linear extent. The aim of this study is to find a possible correspondence. MATERIALS AND METHODS: From a total of 401 consecutive patients submitted to radical prostatectomy, 17 (4.2%) met criteria for insignificant cancer in the surgical specimen. The clinicopathologic findings in the correspondent biopsies were compared with Epstein’s criteria for insignificant cancer. Cancer in a single core was evaluated in percentage as well as linear extent in mm. RESULTS: Comparing the clinicopathologic findings with Epstein’s criteria predictive of insignificant cancer, there was 100% concordance for clinical stage T1c, no Gleason pattern 4 or 5, ≤2 cores with cancer, and no single core with >50% cancer. However, only 25% had density ≤0.15. The mean, median and range of the maximum length of cancer in a single core in mm were 1.19, 1, and 0.5-2.5, respectively. Additionally, the mean, median, and range of length of cancer in all cores in mm were 1.47, 1.5, and 0.5-3, respectively. CONCLUSION: To pathologists that use Epstein’s criteria predictive of insignificant cancer and measure linear extent in mm, our study favors that “no single core with >50% cancer” may correspond to >2.5 mm in linear extent.
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spelling pubmed-47521032016-05-09 Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core? Billis, Athanase Quintal, Maisa M.Q Freitas, Leandro L.L Costa, Larissa B. E. Ferreira, Ubirajara Int Braz J Urol Original Article OBJECTIVE: The aim of active surveillance of early prostate cancer is to individualize therapy by selecting for curative treatment only patients with significant cancer. Epstein’s criteria for prediction of clinically insignificant cancer in surgical specimens are widely used. Epstein’s criterion “no single core with >50% cancer” has no correspondence in linear extent. The aim of this study is to find a possible correspondence. MATERIALS AND METHODS: From a total of 401 consecutive patients submitted to radical prostatectomy, 17 (4.2%) met criteria for insignificant cancer in the surgical specimen. The clinicopathologic findings in the correspondent biopsies were compared with Epstein’s criteria for insignificant cancer. Cancer in a single core was evaluated in percentage as well as linear extent in mm. RESULTS: Comparing the clinicopathologic findings with Epstein’s criteria predictive of insignificant cancer, there was 100% concordance for clinical stage T1c, no Gleason pattern 4 or 5, ≤2 cores with cancer, and no single core with >50% cancer. However, only 25% had density ≤0.15. The mean, median and range of the maximum length of cancer in a single core in mm were 1.19, 1, and 0.5-2.5, respectively. Additionally, the mean, median, and range of length of cancer in all cores in mm were 1.47, 1.5, and 0.5-3, respectively. CONCLUSION: To pathologists that use Epstein’s criteria predictive of insignificant cancer and measure linear extent in mm, our study favors that “no single core with >50% cancer” may correspond to >2.5 mm in linear extent. Sociedade Brasileira de Urologia 2015 /pmc/articles/PMC4752103/ /pubmed/26005981 http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.02.26 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Billis, Athanase
Quintal, Maisa M.Q
Freitas, Leandro L.L
Costa, Larissa B. E.
Ferreira, Ubirajara
Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?
title Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?
title_full Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?
title_fullStr Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?
title_full_unstemmed Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?
title_short Predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?
title_sort predictive criteria of insignificant prostate cancer: what is the correspondence of linear extent to percentage of cancer in a single core?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752103/
https://www.ncbi.nlm.nih.gov/pubmed/26005981
http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.02.26
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