© 2011 Wichtig Editore - ISSN 0391-5603 DOI:10.5301/RU.2011.8541 Urologia ( 2011 ; : 3 ) 184-186 78 184 Carcinoma prostatico insignificante: caratteristiche e fattori predittivi Andrea Vismara Fugini, Alessandro Antonelli, Luca Giovanessi, Valentina Casadei Gardini, Mohannad Abuhilal, Tiziano Zambolin, Regina Tardanico, Claudio Simeone, Sergio Cosciani Cunico Cattedra di Urologia, Università degli Studi di Brescia - Italy *Secondo Servizio di Anatomia Patologica, Spedali Civili di Brescia - Italy Insignificant prostate cancer: charateristics and predictive factors INTRODUCTION. The widespread screening for PSA has contributed to the increased incidence of pros- tate cancer (PCa), mostly identifying disease at earlier stages. Many of these patients will probably not require treatment because of the indolent course of the disease. The European Randomized Study of Screening for Prostate Cancer (ERSPC) has showed that 1410 men needed to be screened and 48 prostatectomies performed to prevent death. The aim of this study was to evaluate predictive factors of insignificant PCa in our experience. MATERIALS AND METHODS. We analyzed various preoperative clinical and biopsy findings of 225 con- secutive patients who underwent prostatectomy from October 2007 to June 2010. The indication for biopsy was placed in presence of an abnormal rectal examination and/or suspected transrectal ultra- sound and/or PSA >4 ng/ml. We consider insignificant a tumor with a volume ≤5% of the entire gland with a Gleason score ≤ 6, with no grades 4 or 5 and organ confined. RESULTS. The prevalence of potentially insignificant PCa in our experience was 12%. The preoperative findings of patients with insignificant PCa were significantly more favorable than the remaining cases with PCa not insignificant. Multivariate analysis did not reveal any independent predictors. CONCLUSIONS: In our experience, in a population not screened for PCa, we have not identified any fac- tors that can predict with certainty the insignificant nature of a tumor and, therefore, useful to start a patient on an active surveillance program. KEY WORDS: Insignificant prostate cancer, Radical prostatectomy, Active surveillance PAROLE CHIAVE: Tumore prostatico insignificante, Prostatectomia radicale, Sorveglianza attiva Accepted: May 26, 2011 MEETING PROCEEDINGS INTRODUZIONE I programmi di screening del PSA hanno determinato un aumento dell’incidenza del Carcinoma prostatico (CaP), in particolare identificato molto precocemente (1). Lo Euro- pean randomised study of screening for prostate cancer (ERSPC) ha dimostrato che 1410 uomini devono essere sottoposti a screening e che 48, con riscontro di CaP, de- vono essere trattati con prostatectomia radicale (PT) per prevenire una morte tumore specifica, evidenziando così la natura potenzialmente insignificante di molti CaP (2). In generale si definisce insignificante dopo PT un tumore di piccolo volume, basso grado ed organo confinato (3). Identificare fattori clinici e bioptici che possano predire la natura clinicamente indolente di un CaP è un obiettivo im- portante per intraprendere un corretto iter terapeutico.