Increasing incidence of minimal residual cancer in radical prostatectomy specimens

摘要: Residual cancer in radical prostatectomy specimens from men with biopsy-proven adenocarcinoma occasionally may be difficult, or even impossible, to identify. Although this finding was recently described as "minimal residual cancer" the "vanishing phenomenon," there are no data on incidence of phenomenon surgical pathology practice. We evaluated 3,038 consecutive prostatectomies performed at Johns Hopkins Hospital between 1988 and 1995, excluding cases a history transurethral resection, prior therapy luteinizing hormone-releasing hormone agonist, focal Gleason grade 4 5, capsular penetration, positive margin. Of group, 84 minimal were identified. In 60 these cases, "difficult find" (mean total volume, 0.03 cc; range, 0.01-0.08 cc); 20 cancers classified "minute" 0.07 0.03-0.13 cc). four could identified, including two which diagnosis needle biopsy confirmed, one case review diagnostic revealed only high-grade prostatic intraepithelial neoplasia, molecular analysis demonstrated mislabeling specimen. The annual increased 0.5% 4% 1993 has begun plateau 3 since (p = 0.0016 for increasing trend). These confirm general impression that more vigilant screening prostate cancer, been an associated increase little prostatectomy.