Clinicopathologic Analysis Of Prostatic Cancer With Single Positive Core Biopsy After Radical Prostatectomy

ObjectiveTo evaluate the clinical and pathological features of patients with prostate cancer who were diagnosed by single positive core biopsy and treated by radical prostatectomy(RP),In order to effectively deliver individualized therapy for patients in such category.And at the same time,we also sought to identify potential risk factor indicating candidate patients who may be classified as pT2 post-operatively.And we also sought to verify the opinion over patients with single positive core prostate carcinoma in the literature that these patients may be taggecorrelation was found between the pre-operative PSA level and Gleason score and pathological stagesd with low in clinical staging,relatively less severe in the post-operative pathological staging and may have a better prognosis.The historical opinion was thus discussed and challenged.Methods1)164 patients with prostate cancer diagnosed by single positive core biopsy underwent RP.We reviewed the pre-and post-operative data of the patients,compared the results of biopsies with pathological examination of the RP samples,and analyzed the preoperative factors influencing pathological results.2)All the charts,surgical and pathological as well as image materials of the patients were reviewed.3)Both the pre-and post-operative pathological diagnosis were reviewed and checked.And all the pathological diagnosis were reviewed and checked by one single senior urological pathologist.Results1)The age of the patients ranged from 41 to 82.The pre-operative PSA were from 0.7 to 59.5 ng/ml(mean 12.3 ng/mL).The pre-operative Gleason score was as follows:113 cases were with the score of 3+3,21 cases were with the score of 3+4,18 cases were with the score of 4+3,and one case was with the score above 8.Ten patients had pT0 disease according to the RP specimen,3 had extraprostatic extensions,5 had seminal vesicle invasions,and 24 had positive surgical margins.2)Compared to the biopsy,the Gleason score of RP specimens was higher in 53 cases,concordant in 77 cases,and lower in 24 cases.3)A statistically significant correlation was found between the pre-operative PSA level and Gleason score and pathological stages.4)The classification of cTlc pri-operatively was significantly associated with increased risk of pT0 stage.Conclusion1)Most single core prostate cancer have clinically significant disease.The treatment plan must be evaluated individually for patients with single core prostate cancer.2)The lower the clinical stage of the patient is established,the more likely that the patient would be classified as pT0 post-operatively.3)Thus,the urologist could consult and discuss with the pathologist in the first place in order to rule out the possibility of false positive pre-operative biopsy pathological findings,and the patient should also be thoroughly informed of the relative risks and potential prognosis before any clinical treatment is administered.