Finding of Prostate Carcinoma at the Capsular End of a Prostate Needle Biopsy Does Not Predict Positive Capsular Margin on Radical Prostatectomy Specimen
Piotr Bernaczyk, Robert Milewski, Lech Chyczewski, Jolanta Kowalewska. Medical University of Bialystok, Bialystok, Poland
Background: The status of surgical margin on radical prostatectomy specimen is considered to be an important prognostic factor in the prediction of postoperative progression of prostate cancer. Needle biopsy of the prostate provides important information that helps to predict pathological stage and margins. Many studies have demonstrated that the percent of cancer on the biopsy, number of positive cores, and fraction of positive cores may predict the status of margins on the subsequent resection. It is not established if the presence of carcinoma at the capsular (proximal) end of the needle biopsy has any prognostic value in prediction of margin involvement on the radical prostatectomy specimen.
Design: A search was conducted through the Department of Pathomorphology database for patients who had diagnostic prostate needle biopsy and subsequently underwent radical prostatectomy for prostate cancer. The results of the biopsy and prostatectomy specimens were reviewed, and the status of the capsular ends (marked with ink) of the needle biopsies was compared to the capsular margin involvement on matched prostatectomy specimen. The statistical software package Statistica 8.0 (StatSoft, Inc., Tulsa, OK) was used to carry out statistical test Chi-square and Fisher exact test; p< 0.05 was considered significant.
Results: One hundred eight (108) patients, mean age 64.4 years (range 51-76), were identified who met the search criteria. Prostate carcinoma was found at the capsular end of 20 (18.5%) needle biopsies, and positive capsular margin was identified on 49 (45.4%) of the radical prostatectomy specimens. There was no statistically significant correlation between these two findings (Chi-Square test: p=0.65, Fisher exact test p=0.41). The sensitivity of finding positive capsular end of the biopsy was 20%, and its positive predictive value was 50%. The negative predictive value was 55.7%.
Conclusions: Our data shows that positive margin on the radical prostatectomy specimen is not related to the finding of prostate carcinoma at the capsular end of the prostate needle biopsy. Therefore, finding of prostate cancer at the capsular end of prostate needle biopsy should not be used as a predictive factor in the assessment of the pathological stage and margins for prostate cancer.
Category: Genitourinary (including renal tumors)
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 160, Wednesday Afternoon