[Use of biopsy results to predict capsular perforation and seminal vesicle invasion in prostate cancer].
OBJECTIVE
To determine the ability of clinical tests to predict extraprostatic cxtension and seminal vesicle invasion.


METHODS
Clinical T stage, TPSA total prostate specific antigen and pathologic features in systematic biopsy specimens were correlated with pathologic stage in 40 consecutive patients with clinically localized prostate cancer detected by systematic needle biopsies and treated with radical prostatectomy.


RESULTS
Extraprostatic extension was observed in 20 patients (50%) and seminal vesicle invasion was noted in 11(28%). Preoperative variables predictors of extraprostatic extension and seminal vesicle invasion on univariate analysis were TPSA, Gleason score, the total length of cancer, the number of positive cores, the percentage of positive cores, the maximum length of cancer in any one core in the biopsy specimen and the percentage of cancer in the biopsy set P<0.05 . In multivariate analysis, TPSA, Gleason score, the total length of cancer and the percentage of positive cores in the biopsy specimens were the only significant predictors of extraprostatic extension and seminal vesicle invasion P<0.01 . A model was constructed to predict advanced stage: the TPSA >or=11 microg x L(-1) and Gleason score/5 and percentage of positive cores in the biopsy specimen >or=27% or the total length of cancer>or=7.3 mm P<0.001 .


CONCLUSIONS
The combination of TPSA, the total length of cancer, Gleason score and percentage of positive cores in the biopsy specimens provides the best prediction of capsular perforation and seminal vesicle invasion. Models based on this combination of factors may be clinically useful to stratify patients for nonoperative treatment.
Li
Guizhong
G
Institute of Urology, Peking University First Hospital, Beijing 100034, China.
Yuan
Yiming
Y
Zhang
Jun
J
Yang
Xinyu
X
Xia
Tongli
T
Guo
Yinglu
Y
Na
Yanqun
Y
D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012669:Seminal Vesicles / Q000473:pathology*