Prostate specimen reevaluation in patients with organ confined prostate cancer and postoperative biological recurrence.

Abstract

We evaluated whether detectable levels of prostate specific antigen after radical prostatectomy for stage P2 disease are associated with unconfined cancer overlooked at pathological examination. Among 129 patients with stages T1 and T2 prostate cancer treated with radical prostatectomy 60 had stage P2 disease. The initial slides from the 7 patients with biological failure were carefully reviewed and, if necessary, the embedded blocks were sectioned every 2 mm. The disease was upstaged histologically from P2 to P3 in 6 of 7 patients by reinspecting the initial slides (3) and examining new slides (3). A postoperative detectable prostate specific antigen level in cases of stage P2 cancer reflects the presence of unconfined disease that may be overlooked by histopathological examination.