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The clinical management of patients with a small volume of prostatic cancer on biopsy: What are the risks of progression?†‡
A systematic review and meta-analysis
Article first published online: 10 JAN 2008
Copyright © 2008 American Cancer Society
Volume 112, Issue 5, pages 971–981, March 2008
How to Cite
Harnden, P., Naylor, B., Shelley, M. D., Clements, H., Coles, B. and Mason, M. D. (2008), The clinical management of patients with a small volume of prostatic cancer on biopsy: What are the risks of progression?. Cancer, 112: 971–981. doi: 10.1002/cncr.23277
See related editorial on pages 966–7, this issue.
This work was initiated for the revision of the guidance on reporting of urological cancers for the Royal College of Pathologists, United Kingdom.
- Issue published online: 19 FEB 2008
- Article first published online: 10 JAN 2008
- Manuscript Accepted: 27 AUG 2007
- Manuscript Revised: 31 JUL 2007
- Manuscript Received: 18 JUN 2007
- United Kingdom National Health Service Cancer Screening Programme
- Cancer Research Wales
- Cancer Research United Kingdom
- prostate cancer;
- microfocal disease;
- insignificant cancer;
- systematic review;
Clinically localized prostate cancer is associated with a wide variation in biologic behavior, and men with the less aggressive form of the disease may never develop symptoms. There has been a rise in prostate cancer incidence in countries in which the blood test for prostatic-specific antigen (PSA) is common, and concerns have been expressed that this may be because of the increased detection of indolent disease, subjecting these men to unnecessary treatment and associated side effects. For the current review, the authors conducted a systematic evaluation of the literature regarding the outcomes of men who were diagnosed on the basis of a small volume of cancer in prostatic biopsies. The results indicated that, despite differences in study design and reporting, a significant proportion of patients with microfocal cancer, regardless of how it was defined, had adverse pathologic findings and a significant risk of PSA recurrence after undergoing radical prostatectomy. Biochemical and clinical recurrences also were observed after radiotherapy or watchful waiting. The authors concluded that patients with microfocal carcinoma on biopsy should be advised that their disease is not necessarily “insignificant” and should be counseled accordingly. Cancer 2008. © 2008 American Cancer Society.