Percentages of positive cores, cancer length and Gleason grade 4/5 cancer in systematic sextant biopsy are all predictive of adverse pathology and biochemical failure after radical prostatectomy

Abstract

Aim:We investigated whether the quantitative parameters of systematic sextant biopsies were predictive of either adverse pathological findings or disease recurrence after radical prostatectomy (RP). Methods: We retrospectively evaluated a total of 117 men with untreated prostate cancer whose needle biopsies were matched with RP specimens. The pretreatment parameters of the serum prostate-specific antigen (PSA), the PSA density, the percentage of positive biopsy cores, the percentage of cancer length and the percentage of Gleason grade 4/5 cancer in the biopsy were determined and compared with the pathological features of prostate cancer in RP specimens. These pretreatment parameters and pathological factors in the RP specimens, including the cancer volume, the percentage of Gleason grade 4/5 cancer, the positive surgical margin and the seminal vesicle invasion were evaluated for their ability to predict the disease recurrence. Results: The percentages of positive biopsy cores, the Gleason grade 4/5 cancer in the biopsy and the cancer length in the biopsy had a weak correlation with the cancer volume in RP specimens (r = 0.373, 0.345, 0.408, respectively). All quantitative biopsy parameters were strongly predictive of the non-organ-confined status, the positive surgical margin and the seminal vesicle invasion in the logistic regression analysis. The percentage of positive biopsy cores and the percentage of Gleason grade 4/5 cancer in the biopsy predicted biochemical failure after RP. Conclusion:These results indicate that quantitative biopsy parameters are independent predictors of the adverse pathology of prostate cancers and disease recurrence after RP.

The correlation among the percentage of positive biopsy cores from the dominant side of prostate, adverse pathology, and biochemical failure after radical prostatectomy

“…Wills et al [18] determined that 89% of patients who had Gleason scores of six or less, number of positive cores two or less, and PSA levels lower than 4 ng/mL had organ-confined disease. However, the number of positive cores was not found to be a useful parameter for the prediction of adverse pathology and biochemical failure after RRP in various studies as it is in our study [9,10]. Recently, PPC in a prostate biopsy was thought to be a significant predictor of an adverse pathology and biochemical failure after RRP.…”

Risk-stratified survival rates and predictors of biochemical recurrence after radical prostatectomy in a Nara, Japan, cohort study

“…Many previous reports mentioned that PSA at diagnosis, biopsy Gleason score, percent positive core, and clinical stage among the preoperative clinicopathological parameters were significant predictors of biochemical recurrence in the patients who underwent radical prostatectomy [4, 5, [8][9][10][11][13][14][15], while surgical Gleason score, ECE, PSM, and PNI were significant predictors among the postoperative pathological parameters [5,9,[16][17][18][19]. Our data showed that PSA at diagnosis, biopsy Gleason score, percent positive core, and PNI were significant predictive parameters of biochemical recurrence in the multivariate analysis.…”

O Percentual de Fragmentos Acometidos na Biópsia como Preditor da Extensão do Câncer de Próstata: Revisão Sistemática

“…Com base nos achados, foi construída uma tabela contendo o nome dos autores e ano das publicações, assim como os dados sobre o número de pacientes, médias de idade, PSA e número de fragmentos colhidos na biópsia, e ainda um resumo dos principais resultados com suas significâncias estatísticas [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] .…”

“…Em 13 trabalhos 6,[8][9][10][11][17][18][19][20][21][22][23][24] , foi realizada avaliação uni e/ou multivariável do valor preditivo do PFA em relação aos achados patológicos da peça cirúrgica, e em todos os estudos, o PFA foi considerado como um excelente preditor do estágio cirúrgico.…”

“…Vários investigadores têm avaliado os parâmetros clínicos e patológicos pré-operatórios dos pacientes com câncer de próstata para a elaboração de algoritmos que predigam a extensão tumoral na peça da prostatectomia radical 3 . Entre as razões para este interesse estão os bons resultados com as outras opções terapêuticas para esses pacientes, como a radioterapia externa e a braquiterapia; a definição pela técnica cirúrgica, como a cirurgia com preservação de nervos ou das vesículas seminais; assim como na presença de comorbidades que excluam a cirurgia como opção de tratamento 6,23 e, ainda, na definição dos pacientes com alto risco de recidiva tumoral que poderiam se beneficiar de uma terapia neoadjuvante ou adjuvante 10 .…”