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
• 期刊代码：267_00904295
• 类别：med
• 出版时间：April, 2012
• 卷：79
• 期：4
• 页码：863-868
• 文件大小：339 K

摘要

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Objective

To evaluate the pathologic outcome of prostate-specific antigen-screened patients with high-grade (Gleason聽score 鈮?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 鈮? (24 cases).

Results

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