Probability of Extraprostatic Disease According to the Percentage of Positive Biopsy Cores in Clinically Localized Prostate Cancer

Abstract

ObjectivePrediction of extraprostatic disease in clinically localized prostate cancer is relevant for treatment planning of the disease. The purpose of this study was to explore the usefulness of the percentage of positive biopsy cores to predict the chance of extraprostatic cancer.Materials and MethodsWe evaluated 1787 patients with localized prostate cancer submitted to radical prostatectomy. The percentage of positive cores in prostate biopsy was correlated with the pathologic outcome of the surgical specimen. In the final analysis, a correlation was made between categorical ranges of positive cores (10% intervals) and the risk of extraprostatic extension and/or bladder neck invasion, seminal vesicles involvement or metastasis to iliac lymph nodes. Student's t test was used for statistical analysis.ResultsFor each 10% of positive cores we observed a progressive higher prevalence of extraprostatic disease. The risk of cancer beyond the prostate capsule for <10% positive biopsy cores was 7.4% and it increased to 76.2% at the category 90-100% positive cores. In patients with Gleason grade 4 or 5, the risk of extraprostatic cancer prostate was higher than in those without any component 4 or 5.ConclusionThe percentage of positive cores in prostate biopsy can predict the risk of cancer outside the prostate. Our study shows that the percentage of positive prostate biopsy fragments helps predict the chance of extraprostatic cancer and may have a relevant role in the patient's management.

Role of metabolic imaging in diagnosis of primary, metastatic, and recurrent prostate cancer

“…The survival and prognosis of patients with extracapsular disease is less favorable compared to patients with localized disease confined to the prostate, highlighting the need for accurate methods of ECE detection [40]. Studies have shown that MRSI/mpMRI has improved the local staging of disease, including the detection of extracapsular spread of disease [41].…”

Open radical cystectomy: still the gold standard for muscle invasive bladder cancer

“…In about 40 % of RC specimens, prostate cancer is incidentally detected of which approximately 20 % are clinically significant. Data on seminal vesicle involvement are scarce; however, in a recent trial in 24.5 % of radical prostatectomy specimen, extraprostatic disease (not necessarily into the seminal vesicles) has been found [33]. This high number has to be kept in mind if considering seminal vesicle sparing.…”