Assessment of Biochemical Recurrence Rate in Patients With Pathologically Confirmed Insignificant Prostate Cancer

ObjectivesTo examine the rate of biochemical recurrence (BCR) in patients with pathologically confirmed insignificant prostate cancer (PIPCa).MethodsA total of 1358 patients underwent open retropubic radical prostatectomy at the University Medical Center Eppendorf in Hamburg, Germany, and their specimens were whole-mounted, step-sectioned, and subjected to computer-based three-dimensional reconstruction. We identified patients who fulfilled the Epstein criteria for definition of PIPCa (tumor volume ≤0.5 mL, Gleason score ≤6, organ-confined disease) and we compared the BCR-free rates between the PIPCa and non-PIPCa groups.ResultsPathologically confirmed insignificant prostate cancer was found in 69 patients (5%). At 1, 2, 5, and 10 years, the BCR-free rate for PIPCa patients was 100% vs, respectively, 97%, 91%, 74%, and 38% for other patients (log–rank P <.0001).ConclusionsIn patients with PIPCa, radical prostatectomy results in perfect biochemical recurrence rates, which confirms the validity of the PIPCa definition.