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.
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References
Antunes AA, Srougi M, Dall′oglio MF et al (2007) Preoperative determination of prostate cancer tumor volume: analysis through biopsy fragments. Int Braz J Urol 33:477–485
Briganti A, Chun FK, Hutterer GC et al (2007) Systematic assessment of the ability of the number and percentage of positive biopsy cores to predict pathologic stage and biochemical recurrence after radical prostatectomy. Eur Urol 52:733–743
Brimo F, Vollmer RT, Corcos J et al (2008) Prognostic value of various morphometric measurements of tumor extent in prostate needle core tissue. Histopathology 53:177–183
D’Amico AW, Whittington R, Malkowicz SB et al (1998) The combination of preoperative prostate specific antigen and postoperative pathological findings to predict prostate specific antigen outcome in clinically localized prostate cancer. J Urol 160:2096–2101
Sebo TJ, Cheville JC, Riehle DL et al (2001) Predicting prostate carcinoma volume and stage at radical prostatectomy by assessing needle biopsy specimens for percent surface area and cores positive for carcinoma, perineural invasion, Gleason score, DNA ploidy and proliferation, and preoperative serum prostate specific antigen: a report of 454 cases. Cancer 91:2196–2204
Lewis JS, Vollmer RT, Humprhey PA (2002) Carcinoma extent in prostate needle biopsy tissue in the prediction of whole gland tumor volume in a screening population. Am J Clin Pathol 118:442–450
Epstein JI, Potter SR (2001) The pathological interpretation and significance of prostate needle biopsy findings: implications and current controversies. J Urol 166:402–410
Goto Y, Ohori M, Arakawa A et al (1996) Distinguishing clinically important from unimportant prostate cancers before treatment: value of systematic biopsies. J Urol 156:1059–1063
Grossklaus DJ, Coffey CS, Shappell SB et al (2002) Percent of cancer in the biopsy set predicts pathological findings after prostatectomy. J Urol 167:2032–2035
Rubin MA, Bassily N, Sanda M et al (2000) Relationship and significance of greatest percentage of tumor and perineural invasion on needle biopsy in prostatic adenocarcinoma. Am J Surg Pathol 24:183–189
Tigrani VS, Bhargava V, Shinohara K et al (1999) Number of positive systematic sextant biopsies predicts surgical margin status at radical prostatectomy. Urology 54:689–693
Wills ML, Sauvegeot J, Partin AW et al (1998) Ability of sextant biopsies to predict radical prostatectomy stage. Urology 51:759–764
Bismar TA, Ewis JS Jr, Vollmer RT et al (2003) Multiple measures of carcinoma extent versus perineural invasion in prostate needle biopsy tissue in prediction of pathologic stage in a screening population. Am J Surg Pathol 27:432–440
Epstein JI, Chan DW, Sokoll LJ et al (1998) Non palpable stage T1c prostate cancer: prediction of insignificant disease using free/total prostatic specific antigen levels and needle biopsy findings. J Urol 160:2407–2411
López JI, Etxezarraga C (2006) The combination of millimeters of cancer and Gleason index in core biopsy is a predictor of extraprostatic disease. Histopathology 48:663–667
Naya Y, Slaton JW, Troncoso P et al (2004) Tumor length and location of cancer in sextant biopsy predict for side specific extraprostatic cancer extension. J Urol 171:1093–1097
Ojea Calvo A, Nuñes Lopez A, Dominguez Freire F et al (2003) Correlation of the anatomo-pathological staging of radical prostatectomy specimens with the amount of cancer in the preoperative sextant biopsy. Actas Urol Esp 27:428–437
Gohji K, Okamoto M, Takenaka A et al (1999) Predicting the extent of prostate cancer using the combination of systematic biopsy and serum prostate-specific antigen in Japanese men. BJU Int 83:39–42
Winkler MH, Khan FA, Kulinskaya E et al (2004) The total percentage of biopsy cores with cancer improves the prediction of pathological stage after radical prostatectomy. BJU Int 94:812–815
Capitanio U, Briganti A, Shariat SF et al (2008) The importance of the quantification of the extent of cancer in prostatic biopsies in prediction of biochemical recurrence: a global perspective. Eur Urol 54:717–719
Pepe P, Fraggetta A, Galia A et al (2008) Is quantitative histologic examination useful to predict nonorgan-confined prostate cancer when saturation biopsy is performed? Urology 72:1198–1202
Cookson MS, Aus G, Burnett AL, Canby-Hagino ED et al (2007) Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American urological association prostate guidelines for localized prostate cancer update panel report and recommendations for a standard in the reporting of surgical outcomes. J Urol 177:540–545
D’Amico AW, Whittington R, Malkowicz SB et al (2000) Clinical utility of the percentage of positive prostate biopsies in defining biochemical outcome after radical prostatectomy for patients with clinically localized prostate cancer. J Clin Oncol 18:1164–1172
Grossfeld GD, Latini DM, Lubeck DP et al (2002) Predicting disease recurrence in intermediate and high risk patients undergoing radical prostatectomy using percent positive biopsies: results from CaPSURE. Urology 59:560–565
Presti JC Jr, Shinohara K, Bacchetti P et al (1998) Positive fraction of systematic biopsies predicts risk of relapse after radical prostatectomy. Urology 52:1079–1084
Freedland SJ, Csathy GS, Dorey F et al (2002) Percent prostate needle biopsy tissue with cancer is more predictive of biochemical failure or adverse pathology after radical prostatectomy than prostate specific antigen or Gleason score. J Urol 167:516–520
Nelson CP, Rubin MA, Strawderman M et al (2002) Preoperative parameters for predicting early prostate cancer recurrence after radical prostatectomy. Urology 59:740–745
Freedland SJ, Aronson WJ, Terris MK et al (2003) The percentage of prostate needle cores with carcinoma from the more involved side of the biopsy as a predictor for prostate specific antigen recurrence after radical prostatectomy: results from the Shared equal access regional cancer hospital (SEARCH) database. Cancer 98:2344–2350
Freedland SJ, Terris MK, Csathy GS et al (2004) Preoperative model for predicting prostate specific antigen recurrence after radical prostatectomy using percent of biopsy tissue with cancer, biopsy Gleason grade and serum PSA antigen. J Urol 171:2215–2220
Sebo TJ, Bock BJ, Cheville JC et al (2000) The percent of cores positive for cancer in prostate needle biopsy specimens is strongly predictive of tumor stage and volume at radical prostatectomy. J Urol 163:174–178
Egawa S, Suyama K, Matsumoto K et al (1998) Improved predictability of extracapsular extension and seminal vesicle involvement based on clinical and biopsy findings in prostate cancer in Japanese men. Urology 52:433–440
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Quintal, M.M.Q., Meirelles, L.R., Freitas, L.L.L. et al. Various morphometric measurements of cancer extent on needle prostatic biopsies: which is predictive of pathologic stage and biochemical recurrence following radical prostatectomy?. Int Urol Nephrol 43, 697–705 (2011). https://doi.org/10.1007/s11255-011-9901-5
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DOI: https://doi.org/10.1007/s11255-011-9901-5