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INTRODUCTION AND OBJECTIVE:Angiomyolipomas (AMLs) are the most common benign renal neoplasm with a strong female predilection, and occur as sporadic, isolated entities in the majority of cases. Amo...

INTRODUCTION AND OBJECTIVE:Unclassified renal cell carcinoma (uRCC) is a rare non-clear cell RCC variant. Next-generation sequencing studies have reported molecular subgroups to be associated with ...

INTRODUCTION AND OBJECTIVE:Immune checkpoint inhibitor (ICI) therapy improves survival in patients with advanced renal cell carcinoma (RCC), but has not been studied preoperatively in patients with...

We evaluated whether the prediction of biochemical recurrence after radical prostatectomy is enhanced by any of 6 parameters, including prostate volume, total tumor volume, high grade total tumor volume, the ratio of high grade total tumor volume to total tumor volume, the ratio of total tumor volume to prostate volume and/or the ratio of high grade total tumor volume to prostate volume.A total of 1,261 patients who underwent radical prostatectomy during a 3-year period had tumor maps constructed with the Gleason pattern denoted as low-3 or high-4 or 5 and volumetric data generated using commercially available software. Univariate Cox regression models were used to assess whether each volume related parameter was associated with biochemical recurrence after radical prostatectomy. A multivariable Cox regression base model (age, prostate specific antigen, Gleason score/grade group, pathological stage and margin status) was compared with 6 additional models (base model plus each volume related parameter) to evaluate enhancement in predictive accuracy. Decision curve analysis was performed to determine the clinical utility of parameters that enhanced predictive accuracy.On univariate analysis each parameter was significantly associated with biochemical recurrence except prostate volume. Predictive accuracy of the multivariable base model was high (c-index = 0.861). Adding volume related parameters marginally enhanced discrimination. Decision curve analysis failed to show added benefit even for high grade total tumor volume/total tumor volume, which was the parameter with the highest discriminative improvement.Tumor volume related parameters are significantly associated with radical prostatectomy but do not add important discrimination to standard clinicopathological variables for radical prostatectomy prediction or provide benefit across a range of clinically relevant decision thresholds. Volume related measurement is not warranted in routine pathological evaluation and reporting.

INTRODUCTION AND OBJECTIVE:Nested variant urothelial carcinoma (NVUC) is a historically aggressive variant of bladder cancer with management reliant on radical cystectomy given unclear effectivenes...

INTRODUCTION AND OBJECTIVES:The diagnosis of atypical small acinar proliferation (ASAP) on prostatic needle biopsy (NB) is associated with a 30-40% cancer detection rate on subsequent NB. In the er...

INTRODUCTION AND OBJECTIVES:Unclassified renal cell carcinoma (uRCC) is a rare non-clear cell RCC variant. Next-generation sequencing studies have reported molecular subgroups with better (mTOR-hyp...

Limited data exist on radical prostatectomy findings performed for cancer on repeat biopsy following an initial atypical biopsy (atypical glands suspicious but not diagnostic for carcinoma).We compared 169 such men to 15,810 without an initial diagnosis of atypical glands suspicious for carcinoma who underwent radical prostatectomy from 1993 to 2008.Median time between atypical biopsy and repeat biopsy showing cancer was 6.1 months (range 0.7 to 94.8). An initial diagnosis of atypical glands suspicious but not diagnostic for carcinoma correlated significantly with nonpalpable disease, biopsy Gleason score 6 and lower tumor volume on needle cores. Compared to radical prostatectomy without prior atypical findings, radical prostatectomy cases with an initial atypical biopsy had a significantly lower Gleason score (p0.0001) and pathological stage (p = 0.001), with 126 (74.5%) Gleason score 6 and 140 (83.0%) organ confined. Only 2 (1.2%) cases showed seminal vesicle involvement and none had lymph node metastases. In addition to known preoperative parameters (clinical stage and biopsy Gleason score), the presence of initial atypical biopsy was an independent predictor of organ confined disease at radical prostatectomy. However, when tumor volume on needle biopsy was included in the multivariate analysis a diagnosis of atypical glands suspicious but not diagnostic for carcinoma lost its independent predictive value.Prostate cancer diagnosed on needle biopsy following a diagnosis of atypical glands suspicious but not diagnostic of carcinoma demonstrates a significantly lower tumor grade and pathological stage at radical prostatectomy than cancer without such a diagnosis. Correlating with lower tumor volume on biopsy, the presence of initial atypical biopsy predicts organ confined disease at radical prostatectomy. However, a few cases with high Gleason score and advanced pathological stage in this group emphasize the importance of re-biopsy within 3 to 6 months following such a diagnosis.