OBJECTIVE: 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. METHODS: 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). RESULTS: 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%). CONCLUSION: 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.
OBJECTIVE: 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. METHODS: 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). RESULTS: 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%). CONCLUSION: 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.
Authors: W C Allsbrook; K A Mangold; M H Johnson; R B Lane; C G Lane; M B Amin; D G Bostwick; P A Humphrey; E C Jones; V E Reuter; W Sakr; I A Sesterhenn; P Troncoso; T M Wheeler; J I Epstein Journal: Hum Pathol Date: 2001-01 Impact factor: 3.466
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Authors: F O'Kelly; S Elamin; A Cahill; P Aherne; J White; J Buckley; K N O'Regan; A Brady; D G Power; M F O'Brien; P Sweeney; N Mayer; P J Kelly Journal: World J Urol Date: 2013-10-16 Impact factor: 4.226
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