High-Grade Prostatic Adenocarcinoma Present in a Single Biopsy Core is Associated With Increased Extraprostatic Extension, Seminal Vesicle Invasion, and Positive Surgical Margins at Prostatectomy

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• 作者：Alcides Chaux^a ; Daniel A. Fajardo^a ; Nilda Gonzalez-Roibon^a ; Alan W. Partin^b ; Mario Eisenberger^c ; Theodore L. DeWeese^c ; George J. Netto^a ; ^b ; ^c ; ^{gnetto1@jhmi.edu}
• 刊名：Urology
• 出版年：2012
• 出版时间：April, 2012
• 年：2012
• 卷：79
• 期：4
• 页码：863-868
• 全文大小：339 K

文摘

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Objective

To evaluate the pathologic outcome of prostate-specific antigen-screened patients with high-grade (Gleason?score ?8) prostate cancer limited to 1 biopsy core, without clinical evidence of disease.

Methods

Ninety-two patients with only 1 biopsy core with cancer and treated by radical prostatectomy were divided into 4 groups according to the biopsy Gleason score: 3 + 3 = 6 (23 cases), 3 + 4 = 7 (25 cases), 4 + 3 = 7 (20 cases), and ? (24 cases).

Results

Cases with Gleason score ? showed a significantly higher proportion of extraprostatic extension (50 % ), positive surgical margins (21 % ), and seminal vesicle invasion (12 % ) when compared with the other groups. Patients with Gleason score ? in the biopsy had a 25-fold increased in the odds ratio for extraprostatic extension in the prostatectomy. The incidence of extraprostatic extension was higher in those with prostatic cancer involving ?0 % of one core (88 % ) compared with cases involving <50 % (32 % ).

Conclusion

In patients with prostate cancer limited to 1 biopsy core, the presence of Gleason score ? significantly increased the incidence of extraprostatic extension, positive surgical margins, and seminal vesicle invasion. The odds ratio was substantially higher in patients with ?0 % of Gleason ? in the biopsy core. These data might be taken into account for proper clinical management of this set of patients.