Is an Extended Prostate Biopsy Scheme Associated with an Improvement in the Accuracy Between the Biopsy Gleason Score and Radical Prostatectomy Pathology? A Multivariate Analysis

To examine whether an extended prostate biopsy (PB) scheme is associated with an improvement in the accuracy between the PB Gleason score (GS) and radical prostatectomy (RP) pathology and to identify probable preoperative variables that stratified patients likely to harbor significant upgrading (SU).

A retrospective review of 538 patients' records diagnosed with prostate cancer (PCa) who underwent RP and exhibited a SU, at two tertiary medical centers, was conducted. The patients were divided into 3 groups: 194 who underwent a 6-core PB (36%), 156 who underwent a 12-core PB (28.9%) and 188 (34.9%) who underwent an 18-core PB. A multivariate analysis was conducted, including prostate-specific antigen (PSA) level, clinical stage, prostate size and duration from PB to RP.

The 6-core group exhibited a 42.7% SU, the 12-core group exhibited a 38.8% SU and the 18-core group exhibited a 14.1% SU. There was a highly significant lower rate of SU in the 18-core than that in the 6-core (p<0.001) and 12-core PB group (p<0.001) but no significant difference in the rate of SU was noted between the 6- and 12-core group (p=0.913). According to the multivariate analysis, only a prostate size of >35 g significantly elevated the probability of SU in the 6-core (p<0.025) and 12-core PB groups (p<0.025), respectively.

An extended PB scheme is associated with a significant improvement in the accuracy between the PB GS and RP pathology. Prostate size >35 g in patients who undergo a 6- or 12-core PB is the only preoperative variable that stratifies patients likely to harbor SU.

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Anticancer research. 2016 Aug [Epub]

Vahudin Zugor, Sandor Poth, Reinhard Kühn, Marija Maja Bernat, Daniel Porres, Apostolos P Labanaris

Department of Urology, University Hospital of Cologne, Cologne, Germany ., Department of Urology, Malteser Kliniken Rhein Ruhr, Krefeld, Germany., Department of Urology, Martha Maria Medical Center, Nurnberg, Germany., Department of Urology, Westpfalz Klinikum, Kaiserslautern, Germany., Department of Urology, University Hospital of Cologne, Cologne, Germany., Department of Urology, Interbalkan Medical Center, Thessaloniki, Greece.