Prognostic value of the percentage of positive fragments in biopsies from patients with localized prostate cancer

Prognostic value of the percentage of positive fragments in biopsies from patients with localized prostate cancer

Author Antunes, Alberto A. Autor UNIFESP Google Scholar
Dall'Oglio, Marcos Francisco Autor UNIFESP Google Scholar
Sant'anna, Alexandre C. Autor UNIFESP Google Scholar
Paranhos, Mario Autor UNIFESP Google Scholar
Leite, Kátia Ramos Moreira Autor UNIFESP Google Scholar
Srougi, Miguel Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract OBJECTIVE: To assess the prognostic value of the percentage of positive fragments (PPF) in biopsies from patients with localized prostate cancer (PCa) undergoing radical prostatectomy. MATERIALS AND METHODS: During the period from March 1991 to November 2000, 440 patients were selected. Cases receiving neoadjuvant or adjuvant hormone therapy, or adjuvant radiotherapy, were excluded, as were cases presenting Gleason scores higher than 6 at biopsy. PPF was defined as the total number of fragments divided by the total number of biopsy fragments times 100. This variable was initially divided into categories from 0 to 25%, 25.1% to 50%, 50.1 to 75% and 75% to 100%. During the postoperative period, patients were assessed every 2 months for 1 year, then every 6 months for 5 years, and then yearly. Biochemical recurrence was defined as serum PSA higher than or equal to 0.4 ng/mL. Median follow-up was 60 months. RESULTS: One hundred and nine (24.8%) of the 440 patients under study had biochemical recurrence. In the univariate analysis, PPF significantly influenced disease-free survival (log-rank, p < 0.001), and patients with PPF between 75 and 100% presented a risk of a biochemical recurrence of the disease 3 times higher than patients with PPF between 0 and 25% (p < 0.001). After the Cox regression analysis, both serum PSA (p = 0.001) and PPF (p < 0.001) showed to be independent predictive factors for disease-free survival following surgery. CONCLUSION: PPF measurement in biopsy is a simple and practical method, which should be routinely used as a predictive factor for biochemical recurrence in patients with PCa presenting Gleason scores between 2 and 6.
Keywords prostatic neoplasms
biopsy
needle
neoplasm staging
Language English
Date 2005-02-01
Published in International braz j urol. Sociedade Brasileira de Urologia, v. 31, n. 1, p. 34-41, 2005.
ISSN 1677-5538 (Sherpa/Romeo)
Publisher Sociedade Brasileira de Urologia
Extent 34-41
Origin http://dx.doi.org/10.1590/S1677-55382005000100007
Access rights Open access Open Access
Type Article
SciELO ID S1677-55382005000100007 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/2388

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