Comparison of Clinical and Pathological Findings in Unifocal and Multifocal Prostate Cancer

Oh, Wook; Song, Sang Yong; Choi, Han Yong

Abstract

PURPOSE: Multifocal prostate cancer has been reported in 50%?85% of all carcinoma cases, but clinical and prognostic significance of this finding is unclear. Patients who underwent radical perineal prostatectomy for localized prostate cancer were retrospectively analysed. The clinical and pathological findings and prognostic significance of prostate cancer focality were assessed.
MATERIALS AND METHODS
Between 1995 and 1998, 28 consecutive radical prostatectomy specimens were reviewed by slicing the specimens into 4mm sections. Preoperative screening parameters, clinical stage and pathological findings including the gleason score, extracapsular extension(ECE), positive surgical margin, vascular invasion, lymph-node invasion, DNA ploidy and p53 etc. were evaluated to assess the prognostic significance of multifocal prostate cancer.
RESULTS
Fifty percent(14/28) of patients had multifocal prostate cancer. There were no statistical differences in the comparison of age, PSA, PSAD, gleason score in needle biopsy, number of needle biopsy with carcinoma between the multifocal and unifocal prostate cancer groups. The preoperative parameters were not able to predict uni- or multifocality. Of the patients with positive surgical margin, 14.3% had unifocal and 42.9% multifocal cancers(p>0.05). Lymph node invasions were detectable in 14.3% of multifocal cases and 0% in unifocal cases(p>0.05). However the postoperative pathologic findings were not significantly different in both groups(p>0.05).
CONCLUSIONS
Although the result of our study was different from the previous reports, based on these findings, it is apparent that a long term follow-up of the patients outcome will be necessary to fully assess the prognostic ability of the cancer focality in men undergoing radical prostatectomy for treatment of prostate adenocarcinoma.