Sextant prostate biopsies. A histopathologic correlation with radical prostatectomy specimens

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Preoperative prediction of tumor volume and pathologic stage in localized prostate cancer remains challenging.
• Transrectal ultrasound-guided sextant biopsies are utilized for disease assessment.

Purpose of the Study:

• To evaluate the efficacy of transrectal ultrasound-guided sextant biopsies in predicting prostate cancer tumor volume and pathologic stage.
• To identify key predictors of disease extent in patients with clinically localized prostate cancer.

Main Methods:

• Systematic sextant biopsies were performed on 102 patients with clinically resectable prostate cancer.
• Radical prostatectomy specimens were analyzed for tumor volume and stage.
• Statistical analysis, including stepwise logistic regression, compared biopsy results with various prognostic factors.

Main Results:

• The number of positive sextant biopsies significantly correlated with preoperative prostate-specific antigen (PSA), tumor volume, pathologic stage, Gleason score, and seminal vesicle involvement.
• Four or more positive biopsies and high Gleason score predicted a higher likelihood of pT3 classification.
• The number of positive biopsies and PSA levels predicted smaller tumor volumes (<0.5 ml), while biopsy count alone predicted larger tumor volumes (>4.0 ml).

Conclusions:

• The number of positive sextant biopsies is a crucial prognostic indicator for predicting pathologic (pT) classification and tumor volume in prostate cancer.
• This predictive information is valuable for optimizing treatment selection in prostate cancer management.