Positive fraction of systematic biopsies predicts risk of relapse after radical prostatectomy

Objectives. To determine whether the positive fraction of systematic sextant biopsies contributes to the prediction of serologic relapse after radical prostatectomy. Methods. A retrospective review of patients who underwent transrectal ultrasound-guided systematic sextant biopsy and radical prostatectomy was performed. No patients received neoadjuvant or adjuvant therapy. The relationship between the positive fraction of systematic biopsies and risk of prostate-specific antigen recurrence was assessed with Kaplan-Meier and multivariate analyses. Results. Patients with three or fewer positive sextant biopsies were at a significantly lower risk of relapse after radical prostatectomy than patients with four or more positive biopsies. Tumor grade and systematic biopsy results were the most powerful predictors of serologic relapse. Conclusions. The positive fraction of systematic biopsies contributes to the prediction of risk of relapse after radical prostatectomy. (C) 1998, Elsevier Science Inc. All rights reserved.