UICC World Cancer Congress 2006

Methods: 717 patients underwent radical prostatectomy for localized prostate cancer at the Urology Service of Walter Reed Army Medical Center. Patients hormonally treated prior to surgery were excluded. Fifty of these had total tumor volumes less than 0.5 cc and minimum of 12 months follow up. All specimens were totally embedded. Biochemical recurrence was defined as two consecutive PSA levels equal to or greater than 0.2 ng/ml.

Results: Median followup was 58 month (range 12 to 117 month), mean age at the time of surgery 61 years old (range 41-74 years old) and mean preoperative PSA was 4.9 ng/ml (range 0.4-19.7 ng/ml). Mean total tumor volume was 0.20 cc (range 0.02-0.45 cc). Most tumors were multifocal (mean total number of tumors was 4). All cases were organ confined (pT2) and surgical margin negative. Nineteen cases had benign glands in the surgical margin. Gleason scores were: 4 (1 case), 5 (9 cases), 6 (37 cases), 3+4 (2 cases). In 1 case the tumor was too small for reliable Gleason scoring. In 5 of 50 cases PSA recurrence up to 5.4 ng/ml were observed. These PSA levels had an undulating pattern. All of these cases were well and/or moderately differentiated tumors (Gleason score 6). In 3 of 5 cases benign glands extended into the surgical margin.