Various morphometric measurements of cancer extent on needle prostatic biopsies: which is predictive of pathologic stage and biochemical recurrence following radical prostatectomy?

Abstract

OBJECTIVES:

To find whether any particular method of measuring cancer extent on needle prostatic biopsies is superior to others in predicting pathological stage >T2 and biochemical recurrence following radical prostatectomy.

MATERIALS AND METHODS:

The study was based on 168 extended biopsies and the correspondent step-sectioned surgical specimens. Tumor extent was evaluated as: (1) number and percentage of cores with carcinoma; (2) total length and percentage of cancer in mm in all cores; and (3) the greatest length and percentage of cancer in a single core.

RESULTS:

All measurements significantly predicted stage >pT2 using logistic regression. With the exception of the greatest length and percentage of cancer in a single core, all other methods were also associated with a higher risk for biochemical recurrence (Cox method). Percentage of length of carcinoma in all cores was significantly and consistently stronger than other measures in all comparisons and combined to preoperative PSA and Gleason grade in multivariate analysis gained prediction for pathologic stage >T2 and was independent of risk of biochemical recurrence.

CONCLUSIONS:

Percentage of total length of carcinoma in mm in all cores of a needle biopsy had the strongest predictive positive value for stage >pT2 and risk for biochemical recurrence following radical prostatectomy. Combined with preoperative PSA and Gleason grade on biopsy may improve the predictive value for stage >pT2.

• Authors: Maisa M Q Quintal, Luciana R Meirelles, Leandro L L Freitas, Luis A Magna, Ubirajara Ferreira, Athanase Billis
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 43 Issue 3 Pg. 697-705 (Sep 2011) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 21340462 (Publication Type: Journal Article)

Chemical References

• Prostate-Specific Antigen

Topics

• Adult
• Aged
• Biopsy, Needle (methods)
• Carcinoma (blood, pathology, surgery)
• Humans
• Logistic Models
• Male
• Middle Aged
• Neoplasm Grading
• Neoplasm Recurrence, Local (blood)
• Predictive Value of Tests
• Proportional Hazards Models
• Prostate-Specific Antigen (blood)
• Prostatectomy
• Prostatic Neoplasms (blood, pathology, surgery)
• Retrospective Studies
• Tumor Burden