Multifocal prostate cancer: biologic, prognostic, and therapeutic implications

Matei Andreoiu, Liang Cheng

Research output: Contribution to journalReview article

146 Scopus citations


Prostatic adenocarcinoma is the most common cancer diagnosed in men and is often multifocal. Ongoing controversy exists about the most appropriate system of tumor classification and grading and the optimal curative treatment approaches. This review examines recent progress in the pathogenesis of multifocal prostatic adenocarcinoma and its biologic, pathologic, prognostic, and therapeutic implications. Prostatic cancer multifocality makes accurate clinical staging difficult, and repeated revisions have been undertaken in an effort to optimize prognostic accuracy. Although the 2010 revision represents an improvement over the previous systems, the clinical significance of the T2 substaging is questionable. Also discussed is the potential impact of tumor multifocality and clonal heterogeneity on the oncologic efficacy of novel focal ablative approaches. The clinical significance of smaller secondary tumors and the relationship between extent of chromosomal abnormalities and the metastatic potential of an individual tumor focus were reviewed.

Original languageEnglish (US)
Pages (from-to)781-793
Number of pages13
JournalHuman pathology
Issue number6
StatePublished - Jun 1 2010


  • Carcinogenesis
  • Field effect
  • Gleason grade
  • Molecular genetics
  • Multifocal
  • Precursor lesions
  • Prostate
  • Prostatectomy
  • Prostatic intraepithelial neoplasia (PIN)
  • Staging
  • TMPRSS2-ERG gene fusion
  • Tumor heterogeneity
  • Tumor volume

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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