High-grade prostatic adenocarcinoma present in a single biopsy core as associated with increased extraprostatic extension, seminal vesicle invasion, and positive surgical margins at prostatectomy - Abstract

Department of Pathology, the Johns Hopkins Medical Institutions, Baltimore, MD.


To evaluate the pathologic outcome of prostate-specific antigen-screened patients with high-grade (Gleason score ≥ 8) prostate cancer limited to 1 biopsy core, without clinical evidence of disease.

Ninety-two patients with only 1 biopsy core with cancer and treated by radical prostatectomy were divided into 4 groups according to the biopsy Gleason score: 3 + 3 = 6 (23 cases), 3 + 4 = 7 (25 cases), 4 + 3 = 7 (20 cases), and ≥8 (24 cases).

Cases with Gleason score ≥8 showed a significantly higher proportion of extraprostatic extension (50%), positive surgical margins (21%), and seminal vesicle invasion (12%) when compared with the other groups. Patients with Gleason score ≥8 in the biopsy had a 25-fold increased in the odds ratio for extraprostatic extension in the prostatectomy. The incidence of extraprostatic extension was higher in those with prostatic cancer involving ≥50% of one core (88%) compared with cases involving < 50% (32%).

In patients with prostate cancer limited to 1 biopsy core, the presence of Gleason score ≥8 significantly increased the incidence of extraprostatic extension, positive surgical margins, and seminal vesicle invasion. The odds ratio was substantially higher in patients with ≥50% of Gleason ≥8 in the biopsy core. These data might be taken into account for proper clinical management of this set of patients.

Written by:
Chaux A, Fajardo DA, Gonzalez-Roibon N, Partin AW, Eisenberger M, Deweese TL, Netto GJ.   Are you the author?

Reference: Urology. 2011 Dec 13. Epub ahead of print.
doi: 10.1016/j.urology.2011.10.012

PubMed Abstract
PMID: 22173174

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