Does the Percentage of Involvement of Prostate Base Needle Core Biopsies by Prostatic Adenocarcinoma Predict Potential Risk of Seminal Vesicle Invasion?
Charles Kovach, Adeboye O Osunkoya. Emory University School of Medicine, Atlanta
Background: Prostatic adenocarcinoma is the most common non-cutaneous cancer in men and is the second leading cause of cancer related deaths in men in the U.S. Unilateral or bilateral seminal vesicle invasion by prostatic adenocarcinoma (pT3b) is typically characterized by poor clinical outcome. Identification of patients who are potentially at increased risk of having seminal vesicle invasion is therefore critical. To date, very few studies have been published regarding the prediction of seminal vesicle invasion at radical prostatectomy based on prostate needle core biopsy findings.
Design: A search was made through the surgical pathology files at our institution for radical prostatectomy cases signed out as prostatic adenocarcinoma with unilateral or bilateral seminal vesicle invasion. Only cases with available prostate needle core biopsies for review were selected. Two groups were established based on the presence or absence of ipsilateral seminal vesicle invasion on radical prostatectomy. The percentage of tumor involvement in each prostate needle core obtained from the base was documented, with emphasis on the core with the greatest tumor volume. The latter was then correlated with the status of the ipsilateral seminal vesicle. A two-tailed t-test was performed to compare the data between the two groups.
Results: A total of 27 cases were selected. Mean patient age was 60 years (range: 46 – 70 years). 7/27 cases (26%) had bilateral seminal vesicle invasion, 12/27 cases (44%) had only right seminal vesicle invasion, and 8/27 cases (30%) had only left seminal vesicle invasion. A total of 54 data points were generated based on the number of cases analyzed and laterality of seminal vesicle involvement. Mean percentage of involvement in the base needle core biopsies that had subsequent ipsilateral seminal vesicle invasion was 66.9% (CI: +/- 8.1%). Mean percentage of involvement in the base needle core biopsies that had no subsequent ipsilateral seminal vesicle invasion was 27% (CI: +/- 16.28%). The differences between the two groups were statistically significant (p = 0.00007).
Conclusions: This study demonstrates a statistically significant correlation between the percentage of involvement of the prostate base needle core biopsy by prostatic adenocarcinoma, and the presence of ipsilateral seminal vesicle invasion. In addition, this study highlights one of the advantages of accurately reporting the percentage of individual cores involved by prostatic adenocarcinoma on prostate needle core biopsies.
Category: Genitourinary (including renal tumors)
Monday, February 28, 2011 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 101, Monday Morning