Single positive core prostate cancer in a 12-core transrectal biopsy scheme: Clinicopathological implications compared with multifocal counterpart
- Authors
- Ahn, H.J.; Ko, Y.H.; Jang, H.A.; Kang, S.G.; Kang, S.H.; Park, H.S.; Lee, J.G.; Kim, J.J.; Cheon, J.
- Issue Date
- 2010
- Keywords
- Biopsy; Prostatectomy; Prostatic neoplasms
- Citation
- Korean Journal of Urology, v.51, no.10, pp.671 - 676
- Indexed
- SCOPUS
KCI
- Journal Title
- Korean Journal of Urology
- Volume
- 51
- Number
- 10
- Start Page
- 671
- End Page
- 676
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/118267
- DOI
- 10.4111/kju.2010.51.10.671
- ISSN
- 2005-6737
- Abstract
- Purpose: The incidence of single positive core prostate cancer at the time of biopsy appears to be increasing in the prostate-specific antigen (PSA) era. To determine the clinical implication of this disease, we analyzed surgical and pathological characteristics in comparison with multiple positive core disease. Materials and Methods: Among 108 consecutive patients who underwent robotic radical prostatectomy following a diagnosis of prostate cancer based on a 12-core transrectal biopsy performed by the same method in a single institute, outcomes from 26 patients (Group 1) diagnosed on the basis of a single positive biopsy core and from 82 patients (Group 2) with multiple positive biopsy cores were analyzed. Results: The preoperative PSA value, Gleason score, prostate volume, and D'Amico's risk classification of each group were similar. The proportion of intermediate + high-risk patients was 69.2% in Group 1 and 77.9% in Group 2 (p=0.22). Total operative time and blood loss were similar. Based on prostatectomy specimens, only 3 patients (11.5%) in Group 1 met the criteria for an indolent tumor (7.31% in Group 2). Although similarities were observed during preoperative clinical staging (p=0.13), the final pathologic stage was significantly higher in Group 2 (p=0.001). The positive-margin rate was also higher in Group 2 (11.5% vs. 31.7%, p=0.043). Despite similarity in upstaging after prostatectomy in each group (p=0.86), upgrading occurred more frequently in Group 1 (p=0.014, 42.5% vs. 19.5%). No clinical parameters were valuable in predicting upgrading. Conclusions: Most single positive core prostate cancer diagnoses in 12-core biopsy were clinically significant with similar risk stratification to multiple positive core prostate cancers. Although the positive-margin rate was lower than in multiple positive core disease, an increase in Gleason score after radical prostatectomy occurred more frequently. © The Korean Urological Association, 2010.
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