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INTRODUCTION AND OBJECTIVES: There is an ongoing debate on removing the label of cancer from Gleason 6 tumors. The aim of the study was to analyze long-term oncological outcomes in patients with pathologic Gleason 3+3 score after radical prostatectomy and to add further knowledge to the discussion. METHODS: We retrospectively analyzed the data of 2942 patients who underwent RP between January 1998 and 2010 and showed a Gleason score 3þ3 in final pathology. Biochemical recurrence (BCR)-free survival, metastasis-free survival (MFS) and cancer-specific survival (CSS) was reported. In multivariate regression analyses further prognosticators of oncological outcome in these patients were analyzed. RESULTS: Median follow-up was 80.7 months. 795 (27.1%) patients underwent lymph node dissection, whereas only one of these patients had positive lymph nodes. Mean preoperative PSA was 6.6 ng/ml, 9.1% of patients had a positive surgical margin and 94.4% had an organ-confined tumor. 198 patients (7.2%) recurred during the follow-up period, 15 (0.5%) patients developed metastasis and 7 (0.2%) patients died of their disease. Patients developing metastases had a significantly higher preoperative PSA (p1⁄40.03) and were more likely to harbor a non-organ-confined tumor (p

Functional neuroimaging implicates hyperactivity of amygdala-orbitofrontal circuitry as a common neurobiological mechanism underlying the development of anxiety. Less is known about anxiety-related structural differences in this network. In this study, a sample of healthy adults with no history of anxiety disorders completed a 3T MRI scan and self-report mood inventories. Post-processing quantitative MRI image analysis included segmentation and volume estimation of subcortical structures, which were regressed on anxiety inventory scores, with depression scores used to establish discriminant validity. We then used a quantitative vertex-based post-processing method to correlate (1) anxiety scores and (2) left amygdala volumes with cortical thickness across the whole cortical mantle. Left amygdala volumes predicted anxiety, with decreased amygdala volume associated with higher anxiety on both state and trait anxiety measures. A negative correlation between left amygdala volume and cortical thickness overlapped with a positive correlation between anxiety and cortical thickness in left lateral orbitofrontal cortex. These results suggest a structural anxiety network that corresponds with a large body of evidence from functional neuroimaging. Such findings raise the possibility that structural abnormalities may result in a greater vulnerability to anxiety or conversely that elevated anxiety symptoms may result in focal structural changes.