title: Tumor length and location of cancer on biopsy predict for side specific extraprostatic cancer extension.
abstract: OBJECTIVE
  We studied preoperative variables in a contemporary series of men who underwent nonnerve sparing radical prostatectomy in an effort to establish criteria that would predict side specific extraprostatic extension (EPE) of cancer.
  
  
  METHODS
  We reviewed the records of 430 patients who underwent radical prostatectomy for localized prostate cancer with no prior therapy between 1996 and 1998, and for whom we had at least sextant biopsy information. We evaluated biopsy data (Gleason score, maximum length of cancer in positive cores, percent of cancer per involved core, proportion of positive biopsy cores, tumor location and number of positive biopsy cores) and correlated these findings with EPE at the neurovascular bundle and posterior lateral (NVB/PL) region.
  
  
  RESULTS
  We found that a higher number of positive cores, a higher biopsy Gleason score on a side, a positive core at the basal region, 50% or greater tumor in the core or a maximum tumor length of 7 mm or greater increased the likelihood that EPE was present at the NVB/PL region on the corresponding side of the prostate. On multivariate analysis maximum tumor length 7 mm or greater and positive basal core location were the strongest independent predictors of EPE at the NVB/PL region on a given side (p <0.0001 and 0.002, respectively).
  
  
  CONCLUSIONS
  Excluding any patient with 1 positive biopsy core with a maximum tumor length of 7 mm or greater plus a positive basal core of any tumor length and grade can decrease the risk of EPE at the NVB/PL region to approximately 10%.
authors.affiliation: Departments of Urology and Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naya
authors.forename: Joel W
authors.initials: JW
authors.lastname: Slaton
authors.forename: Patricia
authors.initials: P
authors.lastname: Troncoso
authors.forename: Koji
authors.initials: K
authors.lastname: Okihara
authors.forename: R Joseph
authors.initials: RJ
authors.lastname: Babaian
mesh_terms: D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery