Location of a positive biopsy as a predictor of surgical margin status and extraprostatic disease in radical prostatectomy.
OBJECTIVE
To investigate whether the location of preoperative biopsy positive cores can identify patients at higher risk of a positive surgical margin (SM) and extraprostatic extension (EPE) at radical retropubic prostatectomy (RRP).


METHODS
We retrospectively reviewed the clinical and pathological data of 371 patients who had a RRP for biopsy confirmed prostate cancer between January 2000 and October 2003.


RESULTS
A positive biopsy at the apex was not predictive of a positive apical SM or EPE. However, a positive biopsy at the base was predictive of a positive basal SM and EPE. A positive SM, in turn, correlated with EPE on final pathology. Positive basal SM correlated with EPE in 75% of cases whereas positive apical SM showed EPE in only 33% (P < 0.02).


CONCLUSIONS
A positive biopsy core at the base appears to correlate with a positive basal SM and EPE. A positive basal SM correlates with EPE at a higher rate than apical SMs.
Touma
Naji J
NJ
Surgery, Division of Urology, University of Western Ontario, London, Ontario, Canada.
Chin
Joseph L
JL
Bella
Tony
T
Sener
Alp
A
Izawa
Jonathan I
JI
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000032:analysis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors
D017430:Prostate-Specific Antigen