Comparison of pathological data between prostate biopsy and radical prostatectomy specimen in patients with low to very low risk prostate cancer

Objective: To analyze the correlation between pathological data found in radical prostatectomy and previously performed biopsy in patients at low risk prostate cancer. Material and methods: A descriptive, cross-sectional study was conducted to assess the characteristics of radical prostatectomies performed in our center from January 2012 to November 2014. The inclusion criteria were patients with low-risk disease (cT1c-T2a, PSA <= 10 ng/mL and Gleason score <= 6). We excluded patients who had fewer than 8 cores in the biopsy, an unspecified number of affected cores, rectal examinations not reported in the medical history or biopsies performed in another center. Results: Of the 184 patients who underwent prostatectomy during this period, 87 met the inclusion criteria, and 26 of these had <3 affected cores and PSA density <= .15 (very low risk). In the entire sample, the percentage of undergrading (Gleason score >= 7) and extracapsular invasion (pT3) was 18.4% (95% CI 10.3 - 27.6) and 10.35% (95% CI 4.6 - 17.2), respectively. The percentage of positive margins was 21.8% (95% CI 12.6-29.9). In the very low-risk group, we found no cases of extracapsular invasion and only 1 case of undergrading (Gleason 7 [3 + 4]), representing 3.8% of the total (95% CI 0-12.5). Predictors of no correlation (stage >= pT3a or undergrading) were the initial risk group, volume, PSA density and affected cores. Conclusions: Prostate volume, PSA density, the number of affected cores and the patient's initial risk group influence the poor pathological prognosis in the radical prostatectomy specimen (extracapsular invasion and Gleason score >= 7). (C) 2014 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.