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

Abstract EN

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.