This was a single center cohort study from January 2009 to June 2016. The authors included patients with PC diagnosed on MRI and targeted transrectal US-guided biopsy who underwent RP. Pathological data collected on RP specimen included tumor localization, Gleason grades of primary (PT) and secondary tumor (ST), presence, location and extent (focal: < 3mm and extended: ≥3mm) of positive surgical margins (PSM). Student test and chi-square analysis were performed.
A total of 1,002 patients were included in the analysis. The median age was 63 years-old (Interquartile range (IQR): 59-68). The median PSA was 6.8 ng/mL (IQR: 5.2-9.5). PT was anterior in 129 cases (13%). In 745 (75%) cases there was a ST. ST was anterior in 92 (13%), posterior in 638 (85%), with missing data in 2%. Median tumor size was 20 mm (IQR: 15-24) for anterior PT (p<0.001) and 16 mm (IQR: 12-22) for posterior PT. Extensive PSM were more common for anterior PT than for posterior PT (19% vs 12%, p=0.04). Gleason grade (p=0.46) and stage (p=0.71) were similar between anterior and posterior PT (Figure 1).
In summary, MRI based detection of PC treated by RP is associated with a 13% anterior location of primary tumor. Anterior cancers share similar grade and stage with posterior cancer but had a larger size and more extensive PSM. Separate oncological outcomes of patient with anterior vs posterior tumors need to be evaluated.
Figure 1: Distribution of primary tumors in prostatectomy specimens. Total is not equal to 100% due to the possibility of an extended tumor involving multiple prostatic areas. SV: Seminal Vesicle
Presented by: Marcq G, Centre Hospitalier Régional Universitaire de Lille, Dept. of Urology, Lille, France
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, twitter: @GoldbergHanan at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark