Contemporary clinicopathological characteristics of pT0 prostate cancer at radical prostatectomy: A population-based study

Background: The incidence of pT0 prostate cancer (CaP) at radical prostatectomy (RP) is extremely rare. We performed the first population-based analysis of pT0 CaP at RP. Methods: Within the Surveillance, Epidemiology, and End Results database (2004–2015), we tested for clinical and pathological characteristics according to pT0 vs. non-pT0 CaP and included a multivariable logistic regression model. Results: pT0 was identified in 358 (0.2%) out of 160,532 clinically localized RP patients. The majority of pT0 patients presented with initial prostate-specific antigen (PSA) <10 ng/ml (82.4%), harboured biopsy Gleason score (GS) 6 (69.8%) and cT1 disease (78.1%). Nonetheless, pT0 was identified in 13 (3.6%) patients with PSA ≥20 ng/ml, in 69 (19.3%) patients with biopsy GS ≥7 and in 78 (21.8%) patients with ≥cT2 disease. In a subset of patients with available number of biopsy cores, pT0 was identified in 34 (33.3%) patients with ≥2 positive biopsy cores. Age, race, marital status, hospital region, population density, PSA, as well as number of biopsy cores did not discriminate between pT0 and non-pT0 cases. Analyses according to annual rates (2004–2015) of pT0 did not vary between the years (0.2%–1.6%, estimated annual percent change: −1.6%, P = 0.3). Neither did the rates vary according to geographic region. Conclusions: pT0 at RP is very rare. Even though, most pT0 patients have low PSA, low clinical stage, low biopsy GS, and only one positive biopsy core, those with more aggressive characteristics can still harbour pT0 at RP.