Preoperative Prostatic Biopsy Factors for the Prediction of Pathologic Stage after Radical Prostatectomy

Sohn, Dong Wan; Park, Hyoung Keun; Byun, Seok Soo; Lee, Sang Eun

Abstract

PURPOSE: To investigate whether the preoperative prostatic biopsy values predict the tumor stage in radical retropubic prostatectomy (RRP) specimens.
MATERIALS AND METHODS
We reviewed the prostatic needle biopsy findings in 69 patients, diagnosed with clinical organ confined prostate cancer, and who underwent a RRP between December 2003 and November 2004. The biopsy specimens were assessed for the number and maximal tumor length of positive cores and for the Gleason score. The preoperative serum prostate-specific antigen (PSA) level and prostate volume were measured using transrectal ultrasonography (TRUS). TRUS guided biopsies of 13.7 2.2 sites were performed. The preoperative values were compared with the pathological stage of the RRP specimens.
RESULTS
Of the 69 patients, 53 (76.8%) had organ confined cancer and 16 (23.2%) had extraprostatic extension (pathologic T2 and T3 or greater, respectively), with mean ages of 65.6 and 65.1 years, respectively. The mean PSA levels were 8.0 and 13.0ng/ml and the prostate volumes were 38.3 and 33.8ml, respectively. The age, prostate volume, biopsy Gleason score and preoperative PSA level were not significant factors for predicting the pathological stage inform a multivariate analysis (p>0.05). The number (p=0.007) and maximal tumor length of positive cores (p=0.046) were significantly higher in those with an extraprostatic stage than in the organ confined cancer group. The optimal maximal tumor length and number of positive cores for the detection of extraprostatic cancer were 7.5mm and 6.5, respectively.
CONCLUSIONS
The number and maximal tumor length of positive cores were strong predictors of the pathologic stage in the RRP specimens.