OBJECTIVE: To analyze the correlation between pathological data found in radical prostatectomy and previously performed biopsy in patients at low risk prostate cancer.
MATERIAL AND METHODS: A descriptive, cross-sectional study was conducted to assess the characteristics of radical prostatectomies performed in our center from January 2012 to November 2014. The inclusion criteria were patients with low-risk disease (cT1c-T2a, PSA≤ 10ng/mL and Gleason score≤ 6). We excluded patients who had fewer than 8 cores in the biopsy, an unspecified number of affected cores, rectal examinations not reported in the medical history or biopsies performed in another center.
RESULTS: Of the 184 patients who underwent prostatectomy during this period, 87 met the inclusion criteria, and 26 of these had< 3 affected cores and PSA density≤ .15 (very low risk). In the entire sample, the percentage of undergrading (Gleason score≥7) and extracapsular invasion (pT3) was 18.4% (95% CI 10.3-27.6) and 10.35% (95% CI 4.6-17.2), respectively. The percentage of positive margins was 21.8% (95% CI 12.6-29.9). In the very low-risk group, we found no cases of extracapsular invasion and only 1 case of undergrading (Gleason 7 [3+4]), representing 3.8% of the total (95% CI 0-12.5). Predictors of no correlation (stage ≥pT3a or undergrading) were the initial risk group, volume, PSA density and affected cores.
CONCLUSIONS: Prostate volume, PSA density, the number of affected cores and the patient's initial risk group influence the poor pathological prognosis in the radical prostatectomy specimen (extracapsular invasion and Gleason score ≥7).
Lendínez-Cano G, Alonso-Flores J, Beltrán-Aguilar V, Cayuela A, Salazar-Otero S, Bachiller-Burgos J. Are you the author?
Servicio de Urología, Consorcio Sanitario Público Aljarafe, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España; Servicio de Atención al Usuario y Calidad, Consorcio Sanitario Público Aljarafe, Hospital San Juan de Dios del Aljarafe, Sevilla, España; Unidad de Salud Pública, Área Sur de Sevilla, Hospital de Valme , Sevilla, España.
Reference: Actas Urol Esp. 2015 Apr 17. pii: S0210-4806(15)00107-2.