[817] Utility of Prostatic Fossa Biopsy in Assessing for Locally Recurrent Prostate Carcinoma: Correlation with PSA and Radical Prostatectomy

J Chow, DB Samadi, PD Unger, HJ Lavery, GQ Xiao. Mount Sinai School of Medicine, New York, NY

Background: Early detection of locally recurrent prostatic carcinoma facilitates early salvage therapy. We explore the correlation of prostatic fossa biopsy results with serum prostate-specific antigen (PSA) values and pathology from prior radical prostatectomies.
Design: We reviewed 15 prostatic fossa biopsies obtained status post radical prostatectomy at our institution from 1997 to 2009. We noted the serum PSA value at the approximate time of the prostatic fossa biopsy. Eight available prostatectomy reports were reviewed.
Results: Prostatic fossa biopsy diagnoses, PSA values at the time of biopsy, and pathology of prior radical prostatectomies are summarized in the Table. No patients had evidence of metastases. The range of PSA values was 8.85 to 30.1 ng/ml for the 4 positive biopsies, 0.11 to 3.2 ng/dl for the 7 biopsies containing benign prostatic glands, and 0.24 to 3.78 ng/ml for the 4 biopsies containing benign fibroconnective tissue. Of the 4 positive biopsies, 3 showed greater than 70% tissue involvement and had the highest PSA values. The 1 biopsy with a small focus of carcinoma had the lowest PSA value.

Summary of Findings

		Radical Prostatectomy
Patient Biopsy Diagnosis	Serum PSA	Gleason Score	Tumor Stage	Margins	Perineural Invasion	% Tumor Involvement
B	0.19	U	U	U	U	U
B	1.2	U	U	U	U	U
B	0.4	3+4	pT2c	-	+	50
P	30.1	U	U	U	U	U
F	3.78	4+3	pT3a	-	+	42
F	0.24	4+4	pT3b	-	+	60
B	0.11	3+4	pT2c	+	+	55
F	2.07	U	U	U	U	U
B	0.53	3+3	pT2a	-	+	20
B	3.2	4+4	pT2a	-	-	20
P	24.31	U	U	U	U	U
B	0.38	U	U	U	U	U
P	19.58	U	U	U	U	U
F	0.45	4+3	pT3a	-	+	15
P	8.85	3+4	pT2c	-	-	U

Abbreviations: P, positive for carcinoma; B, benign prostatic glands; F, fibroconnective tissue; U, unavailable


Conclusions: Positive prostatic fossa biopsies correlated with a high serum PSA. Among the positive biopsies, tumor volume of the biopsy appeared to be associated with PSA level. Negative prostatic fossa biopsies correlated with a low serum PSA. Among the negative biopsies, the presence of benign prostatic glands did not appear to be associated with PSA level. There was no correlation between positivity of the prostatic fossa biopsy and values of various pathologic parameters from the radical prostatectomy. Our study supports the value of obtaining a prostatic fossa biopsy from patients with a high serum PSA to confirm the presence of local disease recurrence.
Category: Genitourinary (including renal tumors)

Monday, March 22, 2010 1:00 PM

Poster Session II # 131, Monday Afternoon