Anterior tumors of the prostate: clinicopathological features and outcomes

To determine whether prostate cancers detected in the anterior vs posterior zones impact clinicopathological features and patient outcomes. This information could potentially affect clinical management.

A retrospective pathological review of 1528 radical prostatectomy specimens submitted between 1989 and 2011 was completed. Specimens were characterized as anterior zone vs posterior zone based on index tumor and predominant tumor volume location. The chi-square test was used to determine associations between tumor location and categorical patient features. Kaplan-Meier unadjusted analysis was used to compare biochemical recurrence-free and overall survival.

Tumors occurred predominantly in the anterior location in 155 (10.1%) of specimens. There was no difference between mean age, body mass index, racial distribution, family history, number of previous biopsies, clinical Gleason sum or pathological stage in the two groups. Fewer patients had clinically palpable disease in the anterior tumor group, 28.8% vs 40.7% (P=0.0150). Pretreatment PSA was lower in the anterior tumor group. Total tumor volume did differ with anterior tumors having a mean 8.3 cc vs 5.6 cc (P<0.0001) size and a higher incidence of positive margins (P=0.0008). There were no differences in biochemical recurrence-free or overall survival.

Despite the potential for adverse pathological features in anterior-based disease, there appears to be no demographic predilection, notable delay in diagnosis or significant difference in survival outcomes.