Kaohsiung Journal of Medical Sciences (Aug 2011)
The correlation among the percentage of positive biopsy cores from the dominant side of prostate, adverse pathology, and biochemical failure after radical prostatectomy
Abstract
The aim of this study was to evaluate the correlation among various preoperative clinical variables, including certain prostate needle biopsy parameters, biochemical failure, and adverse pathology, after radical retropubic prostatectomy (RRP). We retrospectively evaluated the records of our 156 patients who underwent RRP because of localized prostate cancer. Serum prostate-specific antigen level, clinical stage, and the information obtained from biopsy [Gleason score, number of positive cores, percentage of positive cores (PPCs) from the dominant side of prostate, and overall PPC] were evaluated as predictors of adverse pathology and biochemical failure. Of the patients, 30.2% (n=38) had nonorgan-confined disease, 19.1% (n=24) had positive surgical margins, 11.9% (n=15) had positive seminal vesicle invasion, and 16.7% (n=21) had biochemical failure after RRP. Multivariate analysis demonstrated that a PPC value of 55% or more from the dominant side of prostate is the only independent predictor of nonorgan-confined disease and seminal vesicle invasion. Clinical stage (T2b), biopsy Gleason score, and PPC values of 55% or more from the dominant side of prostate were found to be statistically significant predictors of positive surgical margin and biochemical failure. Our results support that PPC from the dominant side of prostate is a useful parameter for the prediction of adverse pathology and biochemical failure after RRP.
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