[Prognostic value in radical prostatectomy of positive cilinders number and cancer percentage per cilinder in prostate biopsy].
BACKGROUND
Clinical stage, PSA value and Gleason score in biopsy are well known independent prognostic factors in prostate cancer. Since the widespread use of PSA, we assist to a changing trend in clinical presentation of patients with prostate cancer toward low stage, low PSA and well-differentiated tumors. This has motivated the search of new prognostic factors to predict those patients at risk of poor outcome. We analyze the histological quantification of tumor in biopsy as a prognostic factor in patients that underwent radical retropubic prostatectomy (RRP).


METHODS
Of a series of 112 RRP performed by the same surgeon, we selected 81 in which tumor quantification at biopsy was assessed.


RESULTS
Comparing the group with up to 2 positive cores against the group with 4 or more, the risk of positive surgical margins in RRP multiplies by 2.4 (15.4% vs. 37.5%), and the risk of biochemical progression almost duplicates (34% vs. 60%). When percentage of tumor per core is analyzed, the presence of 40% or more per core compared to less than 20%, multiplies the risk of positive margins by 5 (44.1% vs. 8.7%), and the risk of biochemical relapse by 3 (48% vs. 15%).


CONCLUSIONS
The total number of positive cores, the percentage of the total of positive cores and the amount of cancer in each core, all demonstrated to be significant predictive prognostic factors that should be analyzed in every patient undergoing prostate biopsy, to predict the risk of poor outcome and therefore help planning the most adequate treatment strategy.
Osorio Pazo
F
F
Cátedra de Urología, Hospital de clínicas Dr. Manuel Quintela, Montevideo, Uruguay.
Mouro Giudice
L
L
Jubin Martínez
J
J
D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies
D017430:Prostate-Specific Antigen