title: Clinicopathologic characteristics of anterior prostate cancer (APC), including correlation with previous biopsy pathology.
abstract: Anterior-predominant prostate cancer (APC) is an incompletely understood entity which can be difficult to sample via transrectal biopsy. Seemingly favorable biopsy results may belie the potential aggressiveness of these tumors. Here, we attempt to characterize APC by retrospectively examining the clinicopathologic features of APC at radical prostatectomy and comparing our findings with prior biopsy information. We found that 17.4 % of patients in our study had APC. APC demonstrated a significantly lower (P value < 0.05) Gleason score (GS) and pathologic stage than non-APC tumors, including the absence of seminal vesicle invasion by APC. A subset (5.6 %) of APC consisted of high-grade tumors (GS ≥ 8), and these tumors were more often detected on transperineal saturation biopsy than non-transperineal saturation (i.e., transrectal ultrasound guided) biopsy strategies. Four patients (7 %) without transperineal saturation biopsy exhibited a significantly worse GS at RP than biopsy, compared to five patients (36 %) with transperineal saturation biopsy. Our findings corroborate the difficulty in detecting APC and suggest that APC is not a uniform disease with a wholly indolent phenotype. Dedicated long-term outcome data are needed in these patients. Additionally, alternative pathologic staging parameters may be necessary.
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Magers
authors.affiliation: Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
authors.forename: Tianyu
authors.initials: T
authors.lastname: Zhan
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Udager
authors.affiliation: Department of Urology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Wei
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.|Michigan Center for Translational Pathology, 1400 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.|Comprehensive Cancer Center, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Tomlins
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Wu
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.|Michigan Center for Translational Pathology, 1400 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Lakshmi P
authors.initials: LP
authors.lastname: Kunju
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Madelyn
authors.initials: M
authors.lastname: Lew
authors.affiliation: Department of Radiation Oncology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Felix Y
authors.initials: FY
authors.lastname: Feng
authors.affiliation: Department of Radiation Oncology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hamstra
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.|Michigan Center for Translational Pathology, 1400 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Javed
authors.initials: J
authors.lastname: Siddiqui
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.|Michigan Center for Translational Pathology, 1400 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.|Comprehensive Cancer Center, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.|Howard Hughes Medical Institute, Ann Arbor, MI, 48109, USA.
authors.forename: Arul M
authors.initials: AM
authors.lastname: Chinnaiyan
authors.affiliation: Department of Urology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Montgomery
authors.affiliation: Department of Urology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Alon Z
authors.initials: AZ
authors.lastname: Weizer
authors.affiliation: Department of Urology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Morgan
authors.affiliation: Department of Urology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Brent K
authors.initials: BK
authors.lastname: Hollenbeck
authors.affiliation: Department of Urology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Miller
authors.affiliation: Department of Urology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors.forename: Ganesh S
authors.initials: GS
authors.lastname: Palapattu
authors.affiliation: Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Pathology, University of Michigan Health System, Room 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA. mrohit@med.umich.edu.|Michigan Center for Translational Pathology, 1400 E. Medical Center Drive, Ann Arbor, MI, 48109, USA. mrohit@med.umich.edu.|Comprehensive Cancer Center, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA. mrohit@med.umich.edu.
authors.forename: Rohit
authors.initials: R
authors.lastname: Mehra
mesh_terms: D001706:Biopsy; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading / Q000379:methods; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies
keywords: Anterior prostate; Biopsy; Prostate cancer; Radical prostatectomy