Prostate biopsy needle as predictor of prostate cancer location in radical prostatectomy

Abstract

Objective: This study evaluates presence of adenocarcinoma in sextant prostate biopsy fragments and corresponding tumor location in surgical specimen in patients undergoing radical prostatectomy without neoadjuvant therapy.
Methodology: From April 2008 to January 2012, forty three sextants prostatic biopsies reports and their corresponding prostatectomy reports were analyzed. Biopsies and reports were performed by a single urologist pathologist in a private hospital in Goiânia. The kappa test was adopted in order to measure the degree of correlation between the variables used.
Results: The mean age of patients was 62.5 years. The more prevalent Gleason score on biopsy was six (90.69%) in accordance with the surgical specimens ( 69.76%). The mean preoperative PSA was 6.1 ng / dl. The most affected region in biopsy was the left apix (46.51%) and in the surgical specimens, the right apex and right base (58.13%) each one. The regions right apex, left apex, right - middle and left base showed a moderate agreement between the localization of prostate cancers on biopsy and surgical specimens with kappa ranging from 0.291 to 0.489 and p value <0.05.
Conclusion: This study showed that the correlation between the location of prostate cancers on biopsy and corresponding location on surgical specimen was moderate and may be due to variability in technical and professional experience and difficulties in technical approach in some prostate regions.