International Urology and Nephrology

, Volume 37, Issue 2, pp 305–310 | Cite as

Significance of the Percentage of Prostate Needle Biopsy Cores with Cancer as a Predictor of Disease Extension in Radical Prostatectomy Specimens in Japanese Men

  • Iori Sakai
  • Ken-ichi Harada
  • Isao Hara
  • Hiroshi Eto
  • Hideaki Miyake


Objectives: To evaluate the significance of the percent of positive biopsy cores (PPBC) with cancer, which has been shown to be one of the most useful predictors of prostate cancer extension in patients undergoing radical prostatectomy. Materials and methods: This study included 120 patients who underwent radical prostatectomy for prostate cancer without any neoadjuvant therapies. All of these patients were diagnosed by random prostate biopsy targeting 8 cores; that is, standard sextant cores and 2 additional cores from the bilateral anterior lateral horns. We evaluated the appropriate cut-off points of PPBC for predicting disease extension according to the number of biopsy cores. Based on these criteria, multivariate analysis was then performed to determine whether PPBC could be an independent factor differentiating organ-confined disease from extraprostatic disease. Results: The most suitable PPBC cut-off value using findings targeting 8 cores for predicting disease extension was 37.5%. If PPBC was calculated based on the outcome of standard sextant cores alone, it is most appropriate to use 33.3% as the cut-off point. Multivariate analysis showed that PPBC calculated based on the standard sextant cores and percent of cancer in the biopsy set could be used as independent factors predicting disease extension irrespective of other biopsy-associated factors. Conclusions: For predicting disease extension, it may be useful to calculate PPBC based on the outcomes of standard sextant biopsy cores alone even if additional cores were taken, and that PPBC calculated in such a way may be the strongest preoperative predictor of prostate cancer extension in Japanese men scheduled for radical prostatectomy.


Extraprostatic extension Percent of positive biopsy core Prostate cancer Radical prostatectomy 


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  1. 1.
    Walsh, PC. 2000Radical prostatectomy for localized prostate cancer provides durable cancer control with excellent quality of life: a structured debateJ Urol16318021807CrossRefPubMedGoogle Scholar
  2. 2.
    Bates, TS, Gillatt, DA, Cavanagh, PM,  et al. 1997A comparison of endorectal magnetic resonance imaging and transrectal ultrasonography in the local staging of prostate cancer with histological correlationBr J Urol79927932PubMedGoogle Scholar
  3. 3.
    Catalona, WJ, Smith, DS, Ratliff, TL,  et al. 1991Measurement of prostate-specific antigen in serum as a screening test for prostate cancerN Engl J Med32411561161PubMedGoogle Scholar
  4. 4.
    Soh, S, Kattan, MW, Berkman, S,  et al. 1997Has there been a recent shift in the pathological features and prognosis of patients treated with radical prostatectomy?J Urol199722122218CrossRefGoogle Scholar
  5. 5.
    O’Dowd, GJ, Veltri, RW, Orozco, R,  et al. 1997Update on the appropriate staging evaluation for newly diagnosed prostate cancerJ Urol158687698CrossRefPubMedGoogle Scholar
  6. 6.
    Vollmer, RT, Keetch, DW, Humphrey, PA. 1998Predicting the pathology results of radical prostatectomy from preoperative informationCancer8315671580CrossRefPubMedGoogle Scholar
  7. 7.
    Katz, AE, Olsson, CA, Raffo, AJ,  et al. 1994Molecular staging of prostate cancer with the use of an enhanced reverse transcriptase-PCR assayUrology43765769CrossRefPubMedGoogle Scholar
  8. 8.
    Hara, I, Miyake, H, Hara, S,  et al. 2001Value of serum prostate specific antigen alpha1-antichymotrypsin complex and its density as a predictor for the extent of prostate cancerBJU Int885357CrossRefPubMedGoogle Scholar
  9. 9.
    Pannek, J, Rittenhouse, HG, Chan, DW,  et al. 1998The use of percent free prostate specific antigen for staging clinically localized prostate cancerJ Urol15912381242CrossRefPubMedGoogle Scholar
  10. 10.
    Gancarczyk, KJ, Wu, H, McLeod, DG,  et al. 2003Using the percentage of biopsy cores positive for cancer, pretreatment PSA, and highest biopsy Gleason sum to predict pathologic stage after radical prostatectomy: The center for prostate disease research nomogramsUrology61589595CrossRefPubMedGoogle Scholar
  11. 11.
    Buyyounouski, MK, Horwitz, EM, Hanlon, AL,  et al. 2003Positive prostate biopsy laterality and implications for stagingUrology62298303CrossRefPubMedGoogle Scholar
  12. 12.
    Sebo, TJ, Bock, BJ, Cheville, JC,  et al. 2000The percent of cores positive for cancer in prostate needle biopsy specimens is strongly predictive of tumor stage and volume at radical prostatectomyJ Urol163174178CrossRefPubMedGoogle Scholar
  13. 13.
    Grossklaus, DJ, Coffey, CS, Shappell, SB,  et al. 2002Percent of cancer in the biopsy set predicts pathological findings after prostatectomyJ Urol16720322036CrossRefPubMedGoogle Scholar
  14. 14.
    Veltri, RW, Miller, MC, Partin, AW,  et al. 2001Prediction of prostate carcinoma stage by quantitative biopsy pathologyCancer9123222328CrossRefPubMedGoogle Scholar
  15. 15.
    Ravery, V, Chastang, C, Toublanc, M,  et al. 2000Percentage of cancer on biopsy cores accurately predicts extracapsular extension and biochemical relapse after radical prostatectomy for T1-T2 prostate cancerEur Urol37449455CrossRefPubMedGoogle Scholar
  16. 16.
    Grossfeld, GD, Chang, JJ, Broering, JM,  et al. 2001Under staging and under grading in a contemporary series of patients undergoing radical prostatectomy: results from the Cancer of the Prostate Strategic Urologic Research Endeavor DatabaseJ Urol165851856CrossRefPubMedGoogle Scholar
  17. 17.
    Lee, AK, Schultz, D, Renshaw, AA,  et al. 2001Optimizing patient selection for prostate monotherapyInt J Radiat Oncol Biol Phys49673677CrossRefPubMedGoogle Scholar
  18. 18.
    Blute, ML, Bergstralh, EJ, Partin, AW,  et al. 2000Validation of Partin tables for predicting pathological stage of clinically localized prostate cancerJ Urol16415911595CrossRefPubMedGoogle Scholar
  19. 19.
    Miyake, H, Hara, S, Yamanaka, K,  et al. 2002Predicting the extent of prostate cancer using a combination of serum prostate specific antigen-alpha1-antichymotrypsin complex and systematic biopsyUrol Int68232236CrossRefPubMedGoogle Scholar
  20. 20.
    Miyake, H, Sakai, I, Ishimura, T,  et al. 2004Significance of cancer detection in the anterior lateral horn on systematic prostate biopsy: the effect on pathological findings of radical prostatectomy specimensBJU Int935759CrossRefGoogle Scholar
  21. 21.
    Sobin, LH, Wittekind, CH. 1997TNM Classification of Malignant Tumors5John Wiley & SonsNew York170173Google Scholar
  22. 22.
    Zietman, AL, Shipley, WU, Coen, JJ. 1994Radical radiation therapy in the management of prostatic adnocarcinoma: the initial prostate specific antigen value as a predictor of treatment outcomeJ Urol151640645PubMedGoogle Scholar
  23. 23.
    Bahn, DK, Lee, F, Solomon, MH,  et al. 1995Prostate cancer: ultrasound guided percutaneous cryoablation: work in progressRadiology194551556PubMedGoogle Scholar
  24. 24.
    Babaian, RJ, Toi, A, Kamoi, K,  et al. 2000A comparative analysis of sextant and an extended 11-core multisite directed biopsy strategyJ Urol163152157CrossRefPubMedGoogle Scholar
  25. 25.
    Presti, JC, Chang, JJ, Bhargava, V,  et al. 2000The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: results of a prospective clinical trialJ Urol163163167CrossRefPubMedGoogle Scholar
  26. 26.
    Wills, ML, Sauvageot, J, Partin, AW,  et al. 1998Ability of sextant biopsies to predict radical prostatectomy stageUrology51759764CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Iori Sakai
    • 1
  • Ken-ichi Harada
    • 1
  • Isao Hara
    • 2
  • Hiroshi Eto
    • 1
  • Hideaki Miyake
    • 1
  1. 1.Department of UrologyHyogo Medical Center for AdultsAkashiJapan
  2. 2.Department of UrologyKobe University School of MedicineKobeJapan

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