PURPOSE: Patients with a single microfocus of prostate cancer (MiFC) at initial biopsy represent the ideal candidates for active surveillance (AS).
We investigate whether the number of cores taken affects the concordance rate between MiFC and the confirmation of a pathologically insignificant prostate cancer (pIPCa) at radical prostatectomy (RP).
MATERIALS AND METHODS: Data were analyzed from 233 patients with a single MiFC at initial transrectal prostate biopsy (a single focus of Gleason 6 involving ≤ 5% of the core) subsequently treated with RP. Chi-square test, cubic-spline analyses and logistic regression analyses were used to depict the relationship between the number of cores taken and the probability of confirming the presence of an indolent disease (pIPCa: RP Gleason score ≤ 6, tumor volume ≤ 0.5 ml, and organ-confined disease).
RESULTS: Overall, 65 patients (27.9%) showed pIPCa at RP. The rate of pIPCa was 3.8%, 29.6%, and 39.4% in patients submitted to ≤ 12 cores, 13-18 cores, and ≥19 cores, respectively (p< 0.001). After adjusting for the available confounders, age (p=0.04), the number of cores taken (p< 0.001), and PSA density (p< 0.02) resulted independent predictors of pIPCa.
CONCLUSIONS: Among patients diagnosed with a single MiFC, the number of biopsy cores taken result a major independent predictor of having confirmed pIPCa at RP. Therefore, when AS is considered as a possible alternative in patients with MiFC, the number of cores taken should be taken into account in decision making.
Written by:
Villa L, Capitanio U, Briganti A, Abdollah F, Suardi N, Salonia A, Gallina A, Freschi M, Russo A, Castiglione F, Bianchi M, Rigatti P, Montorsi F, Scattoni V. Are you the author?
Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, Milan, Italy.
Reference: J Urol. 2012 Sep 25. pii: S0022-5347(12)04996-8.
doi: 10.1016/j.juro.2012.09.100
PubMed Abstract
PMID: 23022004
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