'Vanishing' prostate cancer in radical prostatectomy specimens: incidence and long-term follow-up in 38 cases

BJU International
David G Bostwick, Kathleen C Bostwick

Abstract

To determine the incidence and long-term follow-up of the 'vanishing cancer' phenomenon, as complete sampling of some radical prostatectomy (RP) specimens reveals no residual cancer. The Mayo Clinic prostate cancer RP database for 1966-1995 was searched for all cases in which there was no residual adenocarcinoma (pathological stage pT0). Each case was confirmed by a review of all tissue specimen slides. Various clinical and pathological features were evaluated, and the follow-up obtained for all patients. Among 6843 RPs there were 38 in which no residual cancer was identified despite careful sampling. There was a 10-fold decline in the incidence of this finding, from 2.1% before 1980 to 0.2% in 1993-95; this decline appeared to be caused by a decrease in the frequency of diagnosis of cancer by transurethral resection from > 10% before 1990 to < 2% in 1993-95. The mean (range) age of the patients was 63 (38-75) years. All cancers on biopsy or transurethral resection were well or moderately differentiated; clinical stages included T1a (42% of cases), T1b (45%) and T2 (13%). Six patients had a nerve-sparing RP, all after 1990. The mean follow-up was 9.6 (1.0-28.5) years, and there were no recurrences of cancer; the serum prostate ...Continue Reading

Citations

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