Percentage of cancer on biopsy cores accurately predicts extracapsular extension and biochemical relapse after radical prostatectomy for T1-T2 prostate cancer

Purpose: To perform a multivariate analysis to investigate the usefulness o f eight preoperative variables as predictors of final pathological stage (p T), positive surgical margins (PSM) and biological progression after radica l prostatectomy (RP). Materials and Methods: In 143 patients undergoing RP for T1-T2 prostate can cer, the respective values of age, clinical stage, preoperative prostate-sp ecific antigen (PSA), prostate-specific antigen density (PSAD), number of p ositive biopsies (NPB), Gleason score, length of tissue core invaded by can cer (LTI) and topography (uni/bilaterality) of positive biopsies for predic ting extracapsular extension, PSM and biochemical failure (PSA greater than or equal to 0.05 ng/ml) were evaluated retrospectively. Univariate and mul tivariate analyses were applied to define the statistical significance of e ach variable. Actuarial survival without biological progression was calcula ted using the Kaplan-Meier method (log-rank test). Results: In this series, 44.8% of patients had extracapsular extension with 41.3% PSM. The mean PSA was 12.4 ng/ml. In univariate analysis, LTI (p<0.0 001), NPB (p = 0.0023), PSA (p = 0.0039) and Gleason score (p = 0.0136) wer e the most powerful variables to predict pT stage; however, in logistic reg ression analysis, LTI was the most predictive feature. For prediction of PS M, some variables (LTI, NPB and PSA) were found to be of statistical value in univariate analysis, and LTI in combination with NPB and PSA in multivar iate analysis. For biological progression, statistical analysis (log rank t est) showed PSAD and LTI to be significant predictors. Conclusion: The pathological report regarding the biopsy contains crucial i nformation influencing the prediction of pT stage, PSM and biological progr ession after RP. LTI, NPB and PSA are the most useful parameters for this p urpose. Copyright (C) 2000 S. Karger AG, Basel.