Urology Journal (Sep 2013)
Bilateral Cancer in Prostate Biopsy Associates with the Presence of Extracapsular Disease and Positive Surgical Margins in Low Risk Patients: A Consideration for Bilateral Nerve Sparing Radical Prostatectomy Decision
Abstract
Purpose: To evaluate the epidemiological, clinical and pathological parameters that may predictthe presence of positive surgical margins and extraprostatic disease in patients with low risk [prostatespecific antigen (PSA) < 10, and Gleason score ≤ 6, stage T1c)] prostate cancer.Materials and Methods: We retrospectively analyzed the medical records of patients who hadundergone radical prostatectomy from January 2005 until January 2011. The analysis comprisedpatients’ age, preoperative serum prostate specific antigen (PSA) level, prostate volume, PSA density,biopsy Gleason score, the presence of bilateral disease according to the results of biopsy coresanalysis, the percentage of cancer in biopsy material and the presence of high grade prostatic intraepithelialneoplasia.Results: A total of 117 patients were included in the study. Positive surgical margins were found in37 (31.6%) patients and 23 (19.7%) had advanced disease. The results of the multivariate analysisshowed that bilateral disease was the single significant predictor for advanced disease prediction(P = .04). Same results was obtained by the univariate analysis of the variables for prediction ofpositive surgical margins, where bilateral disease after biopsy cores analysis was the only factor tobe statistical significant (P = .018).Conclusion: Bilateral prostate cancer in prostate biopsy is significantly associated with positivesurgical margins and advanced disease in patients that are operated for prostate cancer of low risk.This observation may assist the selection of patients in whom a bilateral nerve sparing radical prostatectomyis planned to be performed.
