title: A solitary positive prostate cancer biopsy does not predict a unilateral lesion in radical prostatectomy specimens.
abstract: OBJECTIVE
  Prostate cancer (PCa) may be a multifocal and bilateral disease. Patients with low-risk PCa and a low number of positive biopsy cores may choose to undergo active surveillance or focal therapy. The aim of this study was to determine the correlation between a solitary positive prostate biopsy core and the pathological outcome after radical prostatectomy (RP).
  
  
  METHODS
  The Michinoku Japan Urological Cancer Study Group database contains data, including preoperative and postoperative information, on 1268 consecutive patients with PCa treated with RP alone at four institutions. This study focused on 151 patients with a single positive biopsy core, preoperative prostate-specific antigen (PSA) level less than 10 ng/ml, biopsy Gleason score less than 8, and clinical stage T1c/T2a/T2b disease. Potential preoperative predictors of unilateral PCa were age, preoperative PSA level, biopsy Gleason score and clinical T stage.
  
  
  RESULTS
  The median age and preoperative PSA level were 65 years (range 47-76 years) and 6.00 ng/ml (range 0.50-9.80 ng/ml), respectively. Unilateral PCa was identified in 41% of the patients. Extraprostatic extension or seminal vesicle invasion was observed in 26% of all patients.
  
  
  CONCLUSIONS
  Serum PSA levels were significantly higher in the bilateral PCa group than in the unilateral PCa group in the current study. For patients with PCa having a solitary positive prostate biopsy core, definitive therapy such as RP should be considered.
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine , Hirosaki , Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Koie
authors.forename: Koji
authors.initials: K
authors.lastname: Mitsuzuka
authors.forename: Shintaro
authors.initials: S
authors.lastname: Narita
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yoneyama
authors.forename: Sadafumi
authors.initials: S
authors.lastname: Kawamura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kaiho
authors.forename: Norihiko
authors.initials: N
authors.lastname: Tsuchiya
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Tochigi
authors.forename: Tomonori
authors.initials: T
authors.lastname: Habuchi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
authors.forename: Chikara
authors.initials: C
authors.lastname: Ohyama
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen
keywords: needle biopsy; pathological tumor stage; prostate cancer; radical prostatectomy; single positive core; tumor volume