67th Annual Meeting Abstracts
Percent of Prostate Positive Biopsy Cores and Density Analysis in Predicting Prostate Cancer Outcomes
*James C Nederostek, *Bethany B Barone, *Raymond S Lance
Eastern Virginia Medical School, Virginia Beach, VA
Introduction: We investigated the prognostic value of percent positive biopsy (PPB) cores and prostate density on outcomes following radical retropubic prostatectomy (RRP).
Materials & Methods: A cohort of 985 patients who underwent RRP with available biopsy information on number of cores, number of positive cores, and prostate volume was retrospectively reviewed. The PPB cores and prostate density were evaluated for association with 3 outcomes: extracapsular extension (ECE), seminal vesicle invasion (SVI), and biochemical recurrence (BCR) by using logistic and Cox proportional hazards regression, first in univariate models as continuous and then by increasing cutoffs. Independent prognostic ability was assessed by adjusting for biopsy Gleason score, clinical stage, preoperative PSA, and race.
Results: Continuous PPB cores and prostate density were significantly association with ECE, SVI, and BCR in univariate analysis and independently after adjustment for Gleason score, clinical stage, and preoperative PSA. Men with 25-40% and >40% PPB cores or 0.0025-0.0060 and >0.0060 densities had significantly increased risk of ECE after adjustment, with odds ratios ranging from 2.09-5.02. Men with 25-50% and >50% PPB cores or density >0.0060 had significantly increased risk of SVI after adjustment, with odds ratios of 5.16-15.3. Men with >40% PPB cores or density > 0.0130 had significantly increased risk of BCR after adjustment, with hazard ratios of 1.69-2.38. Race was not associated with ECE or SVI, but was marginally associated with BCR.
Conclusions: Greater BBP cores and prostate density are independently associated with an increased risk of ECE, SVI, and BCR following RRP.
