title: Prostate biopsy tumor extent but not location predicts recurrence after radical prostatectomy: results from CaPSURE.
abstract: OBJECTIVE
  Prostate cancer biopsy information is important for patient risk assessment. Although the number and extent of positive biopsies have been used to predict recurrence, the impact of positive biopsy location and contiguity is less clear. We compared the ability of positive prostate biopsy location and pattern with number and percent positive biopsies to predict recurrence after RP.
  
  
  METHODS
  From CaPSURE we identified 2,037 men treated with RP from 1992 to 2002 for whom detailed biopsy information and 2 or more followup PSA values were available. Treatment failure was defined as 2 consecutive PSA values of 0.2 ng/ml or higher, or a second treatment delivered more than 6 months after RP. Biopsy tumor volume (number and percent positive sites), location of disease (anatomical site, laterality), and contiguity of positive biopsies were entered into Cox proportional hazards models to predict risk of disease recurrence while controlling for Gleason grade, PSA and T stage.
  
  
  RESULTS
  Higher number and percent of positive biopsy cores were associated with prostate cancer recurrence, risk stratification category and Gleason grade, p <0.0001, HR 1.09 (CI 1.02 to 1.16) and 1.01 (CI 1.00 to 1.01), respectively. Number of biopsy cores taken, laterality, contiguity and positive biopsy location were not associated with disease recurrence.
  
  
  CONCLUSIONS
  The number and the percentage of biopsies positive for cancer correlated with treatment failure after radical prostatectomy. Contiguity, laterality and location were not associated with recurrence.
authors.affiliation: Department of Urology, University of California, San Francisco Comprehensive Cancer Center, University of California, San Francisco, USA.
authors.forename: Kirsten L
authors.initials: KL
authors.lastname: Greene
authors.forename: Eric P
authors.initials: EP
authors.lastname: Elkin
authors.forename: Armine
authors.initials: A
authors.lastname: Karapetian
authors.forename: Janeen
authors.initials: J
authors.lastname: Duchane
authors.forename: Peter R
authors.initials: PR
authors.lastname: Carroll
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Kane
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012042:Registries