Journal of Clinical Pathology 2008;61:1038-1040
ORIGINAL ARTICLES
Do patients with low volume prostate cancer have prostate specific antigen recurrence following radical prostatectomy?
1 Department of Genitourinary Pathology, Armed Forces Institute of Pathology, Washington, DC, USA
2 Department of Surgery, Urology Service, Walter Reed Army Medical Center, Washington, DC, USA
3 Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
David G McLeod, Center for Prostate Disease Research and Director, Urologic Oncology, 6900 Georgia Ave, NW Washington, DC 20307, USA; dgmcleod{at}verizon.net
Aims: The objective of this study was to determine the incidence of prostate specific antigen (PSA) relapse in patients with low volume prostate cancer following radical prostatectomy.
Methods: Between 1993 and 2001, 50 of 717 patients had total tumour volumes of less than 0.5 cm3 following radical prostatectomy. Biochemical recurrence was defined as two consecutive values of serum PSA levels of 0.2 ng/ml or greater.
Results: Median follow-up of the 50 patients was 58 months. In five of the 50 patients (10%), PSA recurrence was observed. All of these five cases had Gleason score of 3+3 (well and/or moderately differentiated), organ confined and surgical margin negative tumours. In three of the five cases, capsular incision resulted in benign glands extending into the surgical margin.
Conclusions: Five of 50 cases had PSA failure. In three of the five patients, benign glands located in the margin could explain the "PSA recurrence". However, in the other two patients, none of the pathological parameters correlated with measurable PSA levels. The explanation for their PSA failure is unclear.
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