Patients with prostatic cancer undergoing radical prostatectomy after single positive core biopsy: a clinicopathologic analysis of 62 cases

Abstract

To evaluate the clinical and pathological features of patients with prostate cancer who had only one positive biopsy core and underwent radical prostatectomy (RP). A total of 62 patients with prostate cancer who had only one positive biopsy core and underwent RP were enrolled. The clinicopathological features of the biopsy and RP were analyzed. Those factors that may cause discordance of Gleason score (GS) and influence pathological T (pT) stage on RP were further evaluated. Out of the 62 patients, 40(64.5%) had pT stage ≥pT2c. The positive surgical margins, extraprostatic extension and seminal vesicle invasion were found in 17.7%(11/62), 9.7%(6/62) and 3.2%(2/62) of patients, respectively. Compared to GS of RP, that of biopsy specimens was concordant in 39 (62.9%), higher in 6 (9.7%), and lower in 17 (27.4%) patients. There was no significant correlation between GS discordance and age, preoperative PSA level, FPSA/TPSA or maximum percentage of cancer per core (P>0.05). The maximum percentage of cancer per core (χ(2)=6.670 7, P=0.009 8) and biopsy GS (χ(2)=4.020 0, P=0.045 0) were significantly related to the pT stage on RP. Single positive core prostate cancer at biopsy should not be considered as a low-risk disease. Although the preoperative clinicopathological factors cannot predict lower GS on biopsy, the maximum percentage of cancer per core and GS on biopsy are of significance to the pT stage on RP.