Location of a positive biopsy as a predictor of surgical margin status and extraprostatic disease in radical prostatectomy.

Abstract

To investigate whether the location of preoperative biopsy positive cores can identify patients at higher risk of a positive surgical margin (SM) and extraprostatic extension (EPE) at radical retropubic prostatectomy (RRP). We retrospectively reviewed the clinical and pathological data of 371 patients who had a RRP for biopsy confirmed prostate cancer between January 2000 and October 2003. A positive biopsy at the apex was not predictive of a positive apical SM or EPE. However, a positive biopsy at the base was predictive of a positive basal SM and EPE. A positive SM, in turn, correlated with EPE on final pathology. Positive basal SM correlated with EPE in 75% of cases whereas positive apical SM showed EPE in only 33% (P < 0.02). A positive biopsy core at the base appears to correlate with a positive basal SM and EPE. A positive basal SM correlates with EPE at a higher rate than apical SMs.