You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2010301 THE IMPACT OF POSITIVE CORE DENSITY ON PREDICTION OF THE PRETREATMENT STAGE OF PROSTATE CANCER Kent Kanao, Hidaka Kono, Ryuichi Mizuno, Nagata Hirohiko, Eiji Kikuchi, Akira Miyajima, Ken Nakagawa, and Oya Mototsugu Kent KanaoKent Kanao More articles by this author , Hidaka KonoHidaka Kono More articles by this author , Ryuichi MizunoRyuichi Mizuno More articles by this author , Nagata HirohikoNagata Hirohiko More articles by this author , Eiji KikuchiEiji Kikuchi More articles by this author , Akira MiyajimaAkira Miyajima More articles by this author , Ken NakagawaKen Nakagawa More articles by this author , and Oya MototsuguOya Mototsugu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.364AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pretreatment staging of prostate cancer is important because of the increasing use of nonsurgical treatment options. Several studies have shown that the number of positive cores following extended biopsy is associated with the pathological stage and patients with a large prostate volume are more likely to have an organ-confined disease (OCD). However, the number of positive cores and the prostate volume are not used in Partin Tables or in D′amico′s risk stratification. Since establishment of the T stage by digital examination or imaging diagnosis does not have sufficient precision, use of these parameters to determine the treatment option may be important. In this study, we defined the positive core density (PCD) as the number of positive cores divided by the prostate volume and assessed the impact of the PCD on prediction of the pretreatment stage of prostate cancer. METHODS The subjects were 322 men who were treated with radical prostatectomy without neoadjuvant therapy at our institute. All patients were diagnosed by systematic extended biopsy (10 to 12 cores). Age, PSA, clinical stage, biopsy Gleason score, the number of positive cores, and prostate volume calculated by TRUS were analyzed. At first we compared the PCD between OCD patients and other patients. We then examined the PCD in each D′amico′s risk stratification and compared the discriminative ability of the PCD to predict OCD patients with that of Partin Tables using ROC analysis. We also assessed the prognostic significance of PCD for predicting OCD patients using multivariate analysis. RESULTS The age, PSA, number of positive cores, and prostate volume (mean±SE) of the subjects were 64.4±0.32, 9.68±1.35ng/ml, 2.72±0.10 and 37.5±0.89cc. The preoperative clinical stages were T1c in 229 cases, T2a,b in 71, and T2c in 22. The biopsy Gleason scores were ≤6, 7 and ≥8 in 186, 106 and 30 cases. 175 patients were OCD. The PCD of OCD patients (0.068) was significantly lower than that of other patients (0.117). The PCD in the low risk, intermediate and high risk groups in D′amico′s risk stratification were 0.075, 0.096 and 0.115, with significant differences among these groups. On prediction of OCD patients, the area under the ROC curve of PCD (0.682) was higher than that of Partin tables (0.623). In multivariate analysis, PCD was the strongest predictor of OCD patients in all variables.(p<0.01) CONCLUSIONS PCD that is a new concept is a simple and significant parameter for predicting pretreatment stage of prostate cancer, and may be useful in the choice of treatment option. Tokyo, Japan© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e119-e120 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kent Kanao More articles by this author Hidaka Kono More articles by this author Ryuichi Mizuno More articles by this author Nagata Hirohiko More articles by this author Eiji Kikuchi More articles by this author Akira Miyajima More articles by this author Ken Nakagawa More articles by this author Oya Mototsugu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...