Can a gleason 6 or less microfocus of prostate cancer in one biopsy and prostate-specific antigen level 10ng/ml be defined as the archetype of low-risk prostate disease?

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 <10ng/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 < 10ng/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 10ng/ml,clinically significant disease was found in 74.26 patients and only positive surgical margins are useful for predicting the br. © copyright 2012 gianluigi taverna et al.