Extracapular Extension Predictors of Prostate Carcinoma for 2-10 ngr/ ml PSA Values

Abstract

P urpose of the research is to establish which clinical and biopsy parameters could predict extra-capsular spread of prostate carcinoma for 2-10 ng/ml PSA values, in patients submitted to radical retropubic prostatectomy. Methodology: In the period of 30 months, 80 patients were treated with radical retro-pubic prostatectomy with bilateral pelvic lymphadenectomy, for whom clinical, biopsy, radiological and biochemical analysis were positive to organ limited tumor. Serum PSA, fpsa/tpsa, PSAD,values are evaluated, and other parameters as number of positive biopsies, percentage of positive biopsies, localization of positive biopsies, and perineural invasion and biopsy Gleason score. Results: from total number of 80 patients with 2-10 ng/ml PSA, 7 (9%) patients had extra-capsular spread of prostate carcinoma. Upon using multivariate regression analysis, following parameters were proved as significant predictors of extra-capsular spread: biopsy Gleason score, number of positive biopsy samples and invasion, while serum PSA, FPSA/TPSA ratio, PSAD, prostate age and volume have not shown as significant predictors for extra-capsular extension. Conclusion: Biopsy GS, perineural invasion and number of biopsy samples are statistically significant predictors of extra-capsular spread of prostate carcinoma for 2-10 ml PSA. Percentage of positive biopsies, tumor length in a sample and the localization of positive biopsies are on the borderline of statistical significance and as such should be taken into consideration.

Prostate biopsy perineural invasion is not independently associated with positive surgical margins following radical retropubic prostatectomy

“…On review of 1,256 men who underwent RP by a single-surgeon, biopsy PNI was associated with ECE and SVI [18]. Several other studies have also demonstrated an association between PNI on biopsy and ECE at RP [20][21][22][23]. The current study supports these findings with both ECE and SVI independently associated with PNI on prostate biopsy.…”