Clinically insignificant prostate cancer is characterized by limited biologic malignancy and, possibly, it is suitable for non-radical treatment. We performed a retrospective analysis of 1028 patients who underwent radical prostatectomy (118 of them with clinically insignificant prostate cancer), in order to assess the predictors of cancer-related outcome. Only 19% of the patients undergoing radical prostatectomy for clinically insignificant prostate cancer had clinically insignificant cancer in the prostatectomy specimen, whereas in 19% of the cases we found a high-risk disease. The risk of overtreatment is present but currently counterbalanced by the risk of undertreatment.
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