MAAUA: 2007 Abstracts - Percent Core Involvement is an Independent Predictor of Tumor Volume at Radical Prostatectomy in Low Risk Patients With One Single Core of Prostate Cancer on Needle Biopsy

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Percent Core Involvement is an Independent Predictor of Tumor Volume at Radical Prostatectomy in Low Risk Patients With One Single Core of Prostate Cancer on Needle Biopsy
Matthew J Resnick, Daniel J Canter, Thomas J Guzzo, Benjamin M Brucker, Meredith Bergey*, Seema Sonnad*, Alan J Wein, S Bruce Malkowicz
University of Pennsylvania School of Medicine, Philadelphia, PA

INTRODUCTION: Tumor volume is a powerful predictor of outcomes in patients with prostate adenocarcinoma. With widespread implementation of PSA screening, we are detecting more patients with early disease. In attempt to further define potential candidates for watchful waiting or focal therapy, we examined a cohort of patients with one single core of prostate cancer on biopsy to determine whether percent core involvement is a significant predictor of tumor volume at radical prostatectomy.
METHODS: We retrospectively reviewed our database of 2389 patients who underwent radical prostatectomy between 1991 and 2007 to select a group of low risk patients with one single core of prostate cancer on needle biopsy. We then undertook univariate and multivariate regression analyses to evaluate the relationship between percent core involvement and tumor volume at radical prostatectomy.
RESULTS: Of the 2389 patients, 538(22.5%) had one single core of disease on prostate biopsy and reported percent core involvement. Of this group, 376(69.9%) had low risk disease, defined as Gleason score <= 6 and PSA <= 10. Univariate analysis revealed percent core involvement as strongly associated with tumor volume (p=0.026). In our final model including preoperative PSA and age at diagnosis, percent core involvement remained a significant predictor of tumor volume at radical prostatectomy (p=0.014).
CONLCUSIONS: In low risk prostate cancer patients with one single core of prostate cancer on biopsy, percent core involvement is a significant predictor of tumor volume at radical prostatectomy. This data may be used to further counsel patients when considering watchful waiting or focal therapy.

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