title: High-grade prostatic adenocarcinoma present in a single biopsy core is associated with increased extraprostatic extension, seminal vesicle invasion, and positive surgical margins at prostatectomy.
abstract: OBJECTIVE
  To evaluate the pathologic outcome of prostate-specific antigen-screened patients with high-grade (Gleason score ≥ 8) prostate cancer limited to 1 biopsy core, without clinical evidence of disease.
  
  
  METHODS
  Ninety-two patients with only 1 biopsy core with cancer and treated by radical prostatectomy were divided into 4 groups according to the biopsy Gleason score: 3 + 3 = 6 (23 cases), 3 + 4 = 7 (25 cases), 4 + 3 = 7 (20 cases), and ≥ 8 (24 cases).
  
  
  RESULTS
  Cases with Gleason score ≥ 8 showed a significantly higher proportion of extraprostatic extension (50%), positive surgical margins (21%), and seminal vesicle invasion (12%) when compared with the other groups. Patients with Gleason score ≥ 8 in the biopsy had a 25-fold increased in the odds ratio for extraprostatic extension in the prostatectomy. The incidence of extraprostatic extension was higher in those with prostatic cancer involving ≥ 50% of one core (88%) compared with cases involving <50% (32%).
  
  
  CONCLUSIONS
  In patients with prostate cancer limited to 1 biopsy core, the presence of Gleason score ≥ 8 significantly increased the incidence of extraprostatic extension, positive surgical margins, and seminal vesicle invasion. The odds ratio was substantially higher in patients with ≥ 50% of Gleason ≥ 8 in the biopsy core. These data might be taken into account for proper clinical management of this set of patients.
authors.affiliation: Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Alcides
authors.initials: A
authors.lastname: Chaux
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Fajardo
authors.forename: Nilda
authors.initials: N
authors.lastname: Gonzalez-Roibon
authors.forename: Alan W
authors.initials: AW
authors.lastname: Partin
authors.forename: Mario
authors.initials: M
authors.lastname: Eisenberger
authors.forename: Theodore L
authors.initials: TL
authors.lastname: DeWeese
authors.forename: George J
authors.initials: GJ
authors.lastname: Netto
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D001707:Biopsy, Needle; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012669:Seminal Vesicles / Q000473:pathology