Pg. Borboroglu et Cl. Amling, Correlation of positive prostate sextant biopsy locations to sites of positive surgical margins in radical prostatectomy specimens, EUR UROL, 39(6), 2001, pp. 648-653
Objective: To investigate whether sextant location of positive prostate bio
psy predicts the site of positive surgical margins (PSM) at the time of rad
ical prostatectomy (RP) in patients with clinical stage TIC prostate cancer
.
Methods: A retrospective query of the Center for Prostate Disease Research
(CPDR) database at our institution identified 456 patients with clinical st
age T1c prostate cancer who underwent standard sextant prostate biopsy prio
r to RP. Each biopsy was submitted separately for pathologic analysis accor
ding to sextant location. The sextant location of positive biopsies was com
pared to the sites of PSM after RP.
Results: PSM were found in 129 of 456 (28%) RP specimens. The incidence of
PSM at the prostate apex in patients with a positive or negative apical sex
tant biopsy was similar (9 and 8% respectively, p > 0.05). The incidence of
PSM at the prostate base in patients with a positive or negative sextant b
iopsy of the prostate base was also the same (7% in both groups, p>0.05). A
s the number of positive biopsy cores on one side of the prostate increased
(0, 1, 2, and 3) so did the chance of an ipsilateral PSM (5.4, 16.2, 35.7
and 45.0%, respectively; p<0.005).
Conclusions: Positive sextant biopsy location (apex and base) does not corr
elate with site of PSM at RP. However, ipsilateral PSM are more likely as t
he number of positive sextant biopsies on that side increases. While pathol
ogic processing of biopsy specimens according to longitudinal prostate loca
tion (base, mid and apex) is probably unnecessary, the number of positive b
iopsies on a given side may be useful preoperative information. Copyright (
C) 2001 S. Karger AG, Basel.