Ability of sextant biopsies to predict radical prostatectomy stage

被引:96
作者
Wills, ML
Sauvageot, J
Partin, AW
Gurganus, R
Epstein, JI
机构
[1] Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21205 USA
[2] Johns Hopkins Med Inst, James Buchanan Brady Urol Inst, Baltimore, MD 21205 USA
关键词
D O I
10.1016/S0090-4295(98)00011-9
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives. There are few studies evaluating multiple variables on sextant biopsies with the intent to predict stage in radical prostatectomy specimens. Methods. We studied 113 sextant biopsies with corresponding totally submitted radical prostatectomy specimens. Variables evaluated on sextant biopsies included total length and percent of cancer; maximum length and percent of cancer on one core; location taper, mid, base); bilaterality; Gleason grade; number of cores involved; serum prostate-specific antigen (PSA) level; and serum PSA density (PSAD). Radical prostatectomy stage was classified as organ versus non-organ confined. Results. The following variables individually correlated with radical prostatectomy stage: total cancer measured in millimeters (P <0.0001) or percent (P <0.0005); biopsy Gleason score (P <0.0001); number of involved cores (P <0.0001); maximum cancer on one core measured in millimeters (P = 0.0001); maximum percent of cancer on one core (P = 0.01); bilaterality (P = 0.01); PSA level (P = 0.03), and PSAD (P = 0.001). The most predictive sets of two variables that correlated with stage included high Gleason score (P <0.0001) combined with numbers of cores involved (P = 0.002). When biopsies had Gleason scores of 6 or less, two or fewer positive cores, and serum PSA of 0 to 4 ng/mL, 89% were organ confined. When biopsies had Gleason scores of 6 or less with two unilaterally positive cores, 87% were organ confined. In biopsies with Gleason scores of 7 or more and more than one positive core, only 10% were organ confined. Conclusions. The most important predictors of stage by sextant needle biopsy evaluation are numbers of cores involved with carcinoma and high Gleason score. Bilaterality and serum PSA values improved prediction in two small subgroups. In 37% of our population we were able to predict with a greater than 87% probability the organ-confined versus non-organ-confined status. (C) 1998, Elsevier Science Inc. All rights reserved.
引用
收藏
页码:759 / 764
页数:6
相关论文
共 32 条
  • [1] ANALYSIS OF RISK-FACTORS ASSOCIATED WITH PROSTATE-CANCER EXTENSION TO THE SURGICAL MARGIN AND PELVIC NODE METASTASIS AT RADICAL PROSTATECTOMY
    ACKERMAN, DA
    BARRY, JM
    WICKLUND, RA
    OLSON, N
    LOWE, BA
    [J]. JOURNAL OF UROLOGY, 1993, 150 (06) : 1845 - 1850
  • [2] An algorithm for predicting nonorgan confined prostate cancer using the results obtained from sextant core biopsies with prostate specific antigen level
    Badalament, RA
    Miller, MC
    Peller, PA
    Young, DC
    Bahn, DK
    Kochie, P
    ODowd, GJ
    Veltri, RW
    [J]. JOURNAL OF UROLOGY, 1996, 156 (04) : 1375 - 1380
  • [3] COMPARISON OF DIGITAL RECTAL EXAMINATION AND SERUM PROSTATE-SPECIFIC ANTIGEN IN THE EARLY DETECTION OF PROSTATE-CANCER - RESULTS OF A MULTICENTER CLINICAL-TRIAL OF 6,630 MEN
    CATALONA, WJ
    RICHIE, JP
    AHMANN, FR
    HUDSON, MA
    SCARDINO, PT
    FLANIGAN, RC
    DEKERNION, JB
    RATLIFF, TL
    KAVOUSSI, LR
    DALKIN, BL
    WATERS, WB
    MACFARLANE, MT
    SOUTHWICK, PC
    [J]. JOURNAL OF UROLOGY, 1994, 151 (05) : 1283 - 1290
  • [4] THE VOLUME OF PROSTATE-CANCER IN THE BIOPSY SPECIMEN CANNOT RELIABLY PREDICT THE QUANTITY OF CANCER IN THE RADICAL PROSTATECTOMY SPECIMEN ON AN INDIVIDUAL BASIS
    CUPP, MR
    BOSTWICK, DG
    MYERS, RP
    OESTERLING, JE
    [J]. JOURNAL OF UROLOGY, 1995, 153 (05) : 1543 - 1548
  • [5] CORE CANCER LENGTH IN ULTRASOUND-GUIDED SYSTEMATIC SEXTANT BIOPSIES - A PREOPERATIVE EVALUATION OF PROSTATE-CANCER VOLUME
    DIETRICK, DD
    MCNEAL, JE
    STAMEY, TA
    [J]. UROLOGY, 1995, 45 (06) : 987 - 992
  • [6] Impalpable invisible stage tie prostate cancer: Characteristics and clinical relevance in 100 radical prostatectomy specimens - A different view
    Elgamal, AAA
    VanPoppel, HP
    VandeVoorde, WM
    VanDorpe, JA
    Oyen, RH
    Baert, LV
    [J]. JOURNAL OF UROLOGY, 1997, 157 (01) : 244 - 250
  • [7] PATHOLOGICAL AND CLINICAL FINDINGS TO PREDICT TUMOR EXTENT OF NONPALPABLE (STAGE-T1C) PROSTATE-CANCER
    EPSTEIN, JI
    WALSH, PC
    CARMICHAEL, M
    BRENDLER, CB
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1994, 271 (05): : 368 - 374
  • [8] Use of repeat sextant and transition zone biopsies for assessing extent of prostate cancer
    Epstein, JI
    Walsh, PC
    Sauvageot, J
    Carter, HB
    [J]. JOURNAL OF UROLOGY, 1997, 158 (05) : 1886 - 1890
  • [9] INFLUENCE OF CAPSULAR PENETRATION ON PROGRESSION FOLLOWING RADICAL PROSTATECTOMY - A STUDY OF 196 CASES WITH LONG-TERM FOLLOW-UP
    EPSTEIN, JI
    CARMICHAEL, MJ
    PIZOV, G
    WALSH, PC
    [J]. JOURNAL OF UROLOGY, 1993, 150 (01) : 135 - 141
  • [10] PREDICTION OF PROGNOSIS FOR PROSTATIC ADENOCARCINOMA BY COMBINED HISTOLOGICAL GRADING AND CLINICAL STAGING
    GLEASON, DF
    MELLINGE.GT
    [J]. JOURNAL OF UROLOGY, 1974, 111 (01) : 58 - 64