You have accessJournal of UrologyProstate Cancer: Markers (II)1 Apr 20132235 THE NUMBER OF BIOPSY CORES TAKEN IS A MAJOR PREDICTOR OF UNFAVORABLE PROSTATE CANCER AT FINAL PATHOLOGY IN PATIENTS CANDIDATE FOR ACTIVE SURVEILLANCE: CLINICAL IMPLICATIONS Nazareno Suardi, Umberto Capitanio, Andrea Gallina, Firas Abdollah, Niccolo Passoni, Giorgio Gandaglia, Paolo Capogrosso, Nicola Fossati, Paolo Dell'Oglio, Luca Villa, Renzo Colombo, Claudio Doglioni, Giorgio Guazzoni, Andrea Salonia, Francesco Montorsi, and Alberto Briganti Nazareno SuardiNazareno Suardi Milan, Italy More articles by this author , Umberto CapitanioUmberto Capitanio Milan, Italy More articles by this author , Andrea GallinaAndrea Gallina Milan, Italy More articles by this author , Firas AbdollahFiras Abdollah Milan, Italy More articles by this author , Niccolo PassoniNiccolo Passoni Milan, Italy More articles by this author , Giorgio GandagliaGiorgio Gandaglia Milan, Italy More articles by this author , Paolo CapogrossoPaolo Capogrosso Milan, Italy More articles by this author , Nicola FossatiNicola Fossati Milan, Italy More articles by this author , Paolo Dell'OglioPaolo Dell'Oglio Milan, Italy More articles by this author , Luca VillaLuca Villa Milan, Italy More articles by this author , Renzo ColomboRenzo Colombo Milan, Italy More articles by this author , Claudio DoglioniClaudio Doglioni Milan, Italy More articles by this author , Giorgio GuazzoniGiorgio Guazzoni Milan, Italy More articles by this author , Andrea SaloniaAndrea Salonia Milan, Italy More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , and Alberto BrigantiAlberto Briganti Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2144AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Accurate staging is a key pre-requisite for all patients with low risk prostate cancer considered for active surveillance (AS). Despite this, the most commonly used criteria for AS do not include the number of cores taken as a parameter to be considered. We investigated whether the number of cores taken at biopsy affects the rate of unfavorable disease in patients candidates to AS. METHODS Data were analyzed from 449 patients who fulfilled the PRIAS criteria for AS (PSA 10, PSAD ≤20, biopsy Gleason score 6 or lower, clinical T stage 1-2, and 1 or 2 positive cores), subsequently treated with RP at a single tertiary referral center. Chi-square test and cubic spline analyses were used to depict the relationship between the number of cores taken and the probability of finding unfavorable disease(defined as either non organ-confined disease or RP Gleason score 7 or higher) at final pathology. Univariable and multivariable logistic regression analyses were used to identify clinical predictors of unfavorable disease at final pathology. RESULTS Overall, 123 patients (27.4%) showed unfavorable disease at RP. Mean PSA was 5.4 (median 5.5, range 0.5-9.9). The mean number of cores taken was 14 (median 13, range 6-32). At univariable analyses, an increasing number of cores taken was significantly associated with a lower risk of harboring unfavorable disease at RP (OR 0.94: p=0.002). The rate of unfavorable disease was 61.8, 20.8 and 17.4% in men submitted to ≤12, 13-18 and >18 cores at biopsy, respectively (p<0.001). Similarly, even after adjusting for age, PSA, number of positive cores (namely, 2 vs. 1) and prostate volume, the number of cores taken (OR: 0.94; p=0.003)resulted an independent predictor of unfavorable disease. Cubic spline analyses demonstrated a linear effect between the number of cores taken and the risk of harboring unfavorable disease, without reaching any plateau. CONCLUSIONS Among candidates to AS, the number of biopsy cores taken represents a major independent predictor of unfavorable disease at RP. Therefore, when AS is considered as a possible approach, an appropriate number of cores taken at diagnosis is mandatory. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e916 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nazareno Suardi Milan, Italy More articles by this author Umberto Capitanio Milan, Italy More articles by this author Andrea Gallina Milan, Italy More articles by this author Firas Abdollah Milan, Italy More articles by this author Niccolo Passoni Milan, Italy More articles by this author Giorgio Gandaglia Milan, Italy More articles by this author Paolo Capogrosso Milan, Italy More articles by this author Nicola Fossati Milan, Italy More articles by this author Paolo Dell'Oglio Milan, Italy More articles by this author Luca Villa Milan, Italy More articles by this author Renzo Colombo Milan, Italy More articles by this author Claudio Doglioni Milan, Italy More articles by this author Giorgio Guazzoni Milan, Italy More articles by this author Andrea Salonia Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Alberto Briganti Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...