Discordance between location of positive cores in biopsy and location of positive surgical margin following radical prostatectomy.
OBJECTIVE
We compared location of positive cores in biopsy and location of positive surgical margin (PSM) following radical prostatectomy.


METHODS
This retrospective analysis included patients who were diagnosed as prostate cancer by standard 12-core transrectal ultrasonography guided prostate biopsy, and who have PSM after radical prostatectomy. After exclusion of number of biopsy cores <12, and lack of biopsy location data, 46 patients with PSM were identified. Locations of PSM in pathologic specimen were reported as 6 difference sites (apex, base and lateral in both sides). Discordance of biopsy result and PSM was defined when no positive cores in biopsy was identified at the location of PSM.


RESULTS
Most common location of PSM were right apex (n=21) and left apex (n=15). Multiple PSM was reported in 21 specimens (45.7%). In 32 specimens (69.6%) with PSM, one or more concordant positive biopsy cores were identified, but 14 specimens (28%) had no concordant biopsy cores at PSM location. When discordant rate was separated by locations of PSM, right apex PSM had highest rate of discordant (38%). The discordant group had significantly lower prostate volume and lower number of positive cores in biopsy than concordant group.


CONCLUSIONS
This study showed that one fourth of PSM occurred at location where tumor was not detected at biopsy and that apex PSM had highest rate of discordant. Careful dissection to avoid PSM should be performed in every location, including where tumor was not identified in biopsy.
Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Ji Won
JW
Kim
Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Hyoung Keun
HK
Park
Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Hyeong Gon
HG
Kim
Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Dong Yeub
DY
Ham
Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Sung Hyun
SH
Paick
Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Yong Soo
YS
Lho
Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Woo Suk
WS
Choi
D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods
Biopsy; Pathology; Prostate neoplasms; Prostatectomy