BACKGROUND Surveillance and focal therapy are increasingly considered for low risk prostate cancer (PC). and 7% other. The median total tumor volume was 0.38 cm3 (0.003-7.22). Seventy percent of the patients had bilateral tumor and 34% had a tumor nodule >0.5 cm3. The Epirubicin index lesion represented 89% (median) of the total tumor volume. Extraprostatic extension and positive margin were present in 5.7% and 9% of cases respectively. The tumor nodules measuring >0.5 cm3 were located almost equally between the anterior (53%) and peripheral (47%) gland. The relationship between PSA and total tumor volume was weak (r = 0.13 = 0.005). The relationship between PSA density and total tumor volume was slightly better (r = 0.26 < 0.001). CONCLUSIONS Low risk prostate cancer is generally a low volume disease. Gleason score upgrade is seen in 16.9% of cases at radical prostatectomy. While the index lesion accounts for the bulk of the disease the cancer is usually multifocal and bilateral. Neither PSA nor PSA density correlates well with the total tumor volume. Prostate size has a significant contribution to PSA level. These factors need to be considered in treatment planning for low risk prostate cancer. < 0.001) as indicated by the least square line in Physique 1A. The correlations between PSA and total tumor volume (r = 0.13 = 0.005; Fig. 1B) PSAD and Epirubicin total tumor volume (r = 0.26 < 0.001; Fig. 1C) and between BMI and prostate weight (r = 0.25 < 0.001) were statistically significant. The correlations between BMI and PSA (0.06 = 0.26) and BMI and total tumor volume (r = 0.01 = 0.89) were not significant. The median PSA prostate weight total tumor volume and volume of the dominant tumor nodule did not vary significantly between the race groups. Fig. 1 A. Correlation of log(PSA) and log(prostate weight) r = 0.33; < 0.001. B. Correlation of log(PSA) and log(total tumor volume) r = 0.13; = 0.005. C. Correlation of log(PSA density[PSAD]) and log(total tumor volume) r = 0.26; < ... We arbitrarily evaluated the relationship between PSA and tumor volume for patients with PSA ≥4.0 and >4.0 ng/ml (Table I). There was a significant difference in tumor volume (= 0.02) and more statistically significant difference in prostate weight and PSAD (< 0.001 both). The correlation between PSA and total tumor volume for patients with lower PSA Epirubicin was r = 0.26 < 0.001 (Table II). For patients with higher PSA the correlation was not significant (= 0.15). The relationship between PSAD and total tumor volume was stronger for patients with PSA ≤0.4 ng/ml (r = 0.4 < 0.001) and kept its significance for those with PSA >4.0 ng/ml (r =0.2 = 0.001). TABLE I Prostatectomy Findings TABLE Cxcl5 II Correlation of PSA and PSA Density (PSAD) With Total Tumor Volume (TV) DISCUSSION There is a paucity of studies evaluating the pathologic characteristics of PC with the detailed analysis of the prostate submitted entirely for histologic evaluation. This may be due to the fact that it is very labor intensive and is limited to academic institutions with high volume PC programs with dedicated genitourinary pathologists. In the current study we have described the pathologic characteristics Epirubicin in contemporary patients with NCCN low risk PC (PSA <10 ng/ml T1c biopsy Gleason score 3 + 3 = 6). Overall the goal of this manuscript is usually to describe that even in men with low Gleason score (i.e. 3 + 3 = 6) RP there may be significant disease defined by either tumor volume (>0.5 cm3) or stage (pT3a or pT3b). We believe these are important factors to convey that it is not only Gleason score but other factors even in low risk disease may qualify patients as having significant cancer for either focal therapy or surveillance. The patients with Gleason score 3 + 4 = 7 and above at RP were excluded from the analysis because those are significant cancers by grade regardless of other findings. Moreover such NCCN low risk patients whose RP revealed a higher grade cancer were described recently in a study validating the original and modified Epstein criteria in contemporary patients [10]. In the PSA screening era there is an interest in determining whether some of the newly discovered non-palpable (T1c) biopsy confirmed Gleason score 3 + 3 = 6 PCs are in fact not significant that is pose no risk Epirubicin to the patients if no definitive therapy is usually applied. One approach has been to evaluate the volume of the cancer in relation to.