title: Association between Seminal Vesicle Invasion and Prostate Cancer Detection Location after Transrectal Systemic Biopsy among Men Who Underwent Radical Prostatectomy.
abstract: BACKGROUND
  Our hypothesis is that the location of the seminal vesicles near the base of the prostate, the more positive cores are detected in the base, the greater the risk of seminal vesicle invasion. Therefore we investigate the clinical outcomes of base dominant prostate cancer (BDPC) in transrectal ultrasound (TRUS) -guided biopsies compared with anteromiddle dominant prostate cancer (AMPC).
  
  
  METHODS
  From November 2003 to June 2014, a total of 990 intermediate and high risk prostate cancer (PCa) patients who underwent radical prostatectomy (RP) were enrolled and stratified into two groups according to proportion of positive cores-BDPC group had ≥ 33.3% ratio of positive cores from the prostate base among all positive cores and AMPC group < 33.3% in systemic biopsy. Between two groups, we compared the rate of pathologic outcomes and biochemical recurrence (BCR). We performed multivariate logistic regression model to confirm the significance of BDPC to seminal vesicle invasion (SVI) and Cox proportional hazard analysis to BCR.
  
  
  RESULTS
  Among these 990 PCa patients, the 487 patients in BDPC group had more advanced clinical stage (p<0.001), a higher biopsy GS (p = 0.002), and a higher rate of extracapsular extension (ECE), SVI and BCR (all p<0.001) than AMPC group. The patients in BDPC group had poor BCR free survival rate via Kaplan-meier analysis (p<0.001). The ratio of the base positive cores was a significant predictor to SVI in multivariate analysis (p < 0.001) and significant predictor of BCR in multivariate Cox proportional analysis (hazard ratio: 1.466, p = 0.004).
  
  
  CONCLUSIONS
  BDPC in TRUS-guided prostate biopsies was significantly associated with SVI and BCR after adjusting for other clinical factors. Therefore, BDPC should be considered to be a more aggressive tumor despite an otherwise similar cancer profile.
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Young Ik
authors: YI
authors: Lee
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Hak Min
authors: HM
authors: Lee
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Jung Ki
authors: JK
authors: Jo
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Sangchul
authors: S
authors: Lee
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Sung Kyu
authors: SK
authors: Hong
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Seok-Soo
authors: SS
authors: Byun
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Sang Eun
authors: SE
authors: Lee
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Jong Jin
authors: JJ
authors: Oh
mesh_terms: D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012669:Seminal Vesicles / Q000473:pathology*
chemical_list: D017430:Prostate-Specific Antigen