UroToday - In the August 2008 issue of Cancer, Dr. Felix Chun and associates present data to discriminate between men with indolent and important prostate cancer (CaP) to help stratify those electing active surveillance (AS). The authors point out that even the criteria suggested by Dr. Epstein and the nomogram by Dr. Kattan will only have about 80% accuracy at radical prostatectomy (RP) for estimating insignificant prostate cancer (ICaP). The criteria most commonly applied are no more than 2 positive biopsy cores positive with up to 50% cancer involvement, biopsy Gleason sum of 6 or less, and PSA density less than 0.15.

Between 1992 and 2003, clinical and pathologic data prospectively gathered on 1,153 men with CaP who underwent RP at the investigators' institution was used for the analysis. Clinically ICaP was defined as organ-confined disease with total volume

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